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European Journal of Heart Failure 2002 4(4):553-558; doi:10.1016/S1388-9842(02)00087-9
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© 2002 European Society of Cardiology

Cost-effectiveness of the treatment of heart failure with ramipril: a Spanish analysis of the AIRE study

Warren Mark Harta, Carlos Rubio-Terresb,*, Francisco Pajuelob and Jose R. González Juanateyc

a EcoStat Consulting Group San Sebastián, Spain
b Scientific Department, Aventis Pharma, S.A., Servicios Científicos, C/Martínez Villergas 52, 28027 Madrid, Spain
c Cardiology Department, Complejo Hospitalario de Santiago Santiago de Compostela, Spain

* Corresponding author. Tel.: +34-91-724-5745; fax: +34-91-724-5699 E-address: carlos.rubio{at}aventis.com


  Abstract

Aims: To estimate the cost-effectiveness of adding ramipril to conventional treatment in patients with heart failure after myocardial infarction from the perspective of the Spanish National Health System.

Methods and results: A retrospective analysis of the AIRE study was made, using previously published data from the clinical trial combined with local Spanish resource and cost data. A typical rehospitalisation for a heart failure episode would last an average of 11.6 days with an average cost of {euro}350.80 per day. The incremental cost of ramipril per life-year gained in the baseline case was {euro}1550.10 after 3.8 years of follow-up. Sensitivity analysis showed that the basic conclusions were robust in spite of extreme variations in the values of the key parameters of the model.

Conclusion: The use of ramipril in addition to conventional treatment in heart failure patients after myocardial infarction is cost-effective both according to currently accepted international standards of what constitutes a cost-effective intervention and also indirectly by comparing the results with similar pharmaceutical products financed under the Spanish National Health System.

Key Words: Heart failure • Cost-effectiveness • Ramipril • Spain

Received July 5, 2001; Revised November 22, 2001; Accepted February 4, 2002


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