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Studies with classical clinical endpoints indicated comparable efficacy and tolerability of the two loop diureties torasemide and furosemide in congestive heart failure (CHF). However, differences in the pharmacological profiles suggested potentially different quality of disease control under real life conditions. OBJECTIVE: The present study aimed at collecting data in a naturalistic setting and comparing overall cost and cost‐effectiveness of torasemide and furosemide. METHODS: Data on the course of the disease and on related resource utilization were collected retrospectively from a one‐year treatment period of 200 torasemidetreated and 200 furosemide‐treated patients. High comparability of the two patient groups was achieved by using the matched‐pair method with nine demographic and medical matching criteria. RESULTS: Disease control was better in the torasemide patients, as reflected by fewer hospital days due to CHF (324 vs. 62) and more patients with improvement of NYHA class (torasemide: 38.0% [31.25%–45.11%]; furosemide: 24.5% [18.71%–31.06%]) during the observation period. Comparing overall cost from the statutory health insurance's perspective, torasemide treatment is less costly by 361 DEM per patient and year (1502 vs. 1863 DEM). Moreover, torasemide is clearly more cost‐effective: The cost per patient with improved NYHA class is 3954 DEM for torasemide versus 7605 DEM for furosemide. Analyses from the societal perspective yielded similar results. CONCLUSIONS: The data reveal substantial improvement of disease control and reduction of treatment cost with torasemide compared to furosemide. Furthermore, this study highlights the value of collecting naturalistic data from balanced populations to improve our understanding of drug effects on disease courses and health care cost.

Background: Cardiac arrest is a critical condition with high clinical, economic, and emotional burden. The role of palliative medicine in the management of critical patients has grown and, in some areas, has shown reduced cost of stay. This study set out to examine the association of palliative care involvement in out of hospital post cardiac arrest patients and cost of stay. Methods: This is a single center retrospective analysis of all patients ≥18 years of age who were admitted at our institution from March 2018 to June 2019 with out of hospital cardiac arrest. Patients who immediately died in the emergency department were excluded. Patients were then classified according to whether palliative care was consulted. Total charges were obtained from the billing records and compared between those with palliative care compared to those without using Mann–Whitney U test. Results: A final sample of 98 patients that were included in the analysis. The mean age was 61.2 ± 17.3, 46% were female, and 61% were African American. Palliative care consultation was present in 27 (28%) of patients. There were no significant differences among age, gender, ethnicity, BMI, SOFA scores, and common comorbidities among those who did and did not have palliative care consultation. While there was a significantly longer ICU length of stay and mechanical ventilation days among patients with palliative care involvement P < .0001, the charges among patients with palliative care involvement were not statistically significantly different $59,245 ($3744-148,492) (median IQR) compared to those without palliative care $79,521 ($6540-157,952) P = .762. Conclusion: Length of stay increased with palliative care consultation which may relate more to the inherent clinical scenario. Cost of stay was not statistically significantly different.

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