PCV7 Economic Evaluation of Torasimide in Congestive Heart Failure in Germany

Abstract

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.

Economics of chronic heart failure

“…In one German study, only 9.3% of 400 patients studied were working. However, during a 1‐year period, eight patients were absent from work for a total of 1058 days, which, based on the average German salary in 1996, equated to an indirect cost of DM415 per patient year [64]. In the SUPPORT study, patients who were consulted by a cardiologist were more likely to have an income of over $11 000 per year, than those treated by a general physician [38].…”