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Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy

Chronic heart failure (HF) is a major cause of morbidity and mortality particularly in the elderly and a growing healthcare burden in Italy. The objective was to assess the cost-effectiveness of candesartan cilexetil, an angiotensin II type 1 receptor blocker (ARB) for the treatment of HF. A pre-spe...

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Autores principales: Colombo, Giorgio L, Caruggi, Mauro, Ottolini, Chiara, Maggioni, Aldo P
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2008
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464765/
https://www.ncbi.nlm.nih.gov/pubmed/18629370
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author Colombo, Giorgio L
Caruggi, Mauro
Ottolini, Chiara
Maggioni, Aldo P
author_facet Colombo, Giorgio L
Caruggi, Mauro
Ottolini, Chiara
Maggioni, Aldo P
author_sort Colombo, Giorgio L
collection PubMed
description Chronic heart failure (HF) is a major cause of morbidity and mortality particularly in the elderly and a growing healthcare burden in Italy. The objective was to assess the cost-effectiveness of candesartan cilexetil, an angiotensin II type 1 receptor blocker (ARB) for the treatment of HF. A pre-specified economic evaluation was conducted on resource utilization (cardiovascular drug treatment, cardiovascular and non-cardiovascular hospital admission, cardiovascular procedures/operations) prospectively collected alongside the CHARM program, a series of parallel randomized clinical trials comparing candesartan with placebo (standard therapy) in patients with NYHA Class II-IV HF: CHARM-Alternative (LVEF ≤40% patients not receiving ACE inhibitors because of previous intolerance); CHARM-Added (LVEF ≤40% patients currently receiving ACE inhibitors); or CHARM-Preserved (LVEF ≥40% patients). The primary outcome for the component trials was the composite of cardiovascular death or worsening hospital admission for HF and of the overall program all-cause mortality. Adjunctive treatment with candesartan in CHARM-Alternative and CHARM-Added led to clinical benefits and to either cost-savings or a small additional cost, depending on the trial. The less certain clinical benefit in CHARM-Preserved was obtained at modest extra cost. The incremental cost-effectiveness ratios (ICERs) were estimated to range from €713 per life year gained for CHARM-Alternative to dominant for CHARM-Added and the pooled reduced LVEF trials.
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spelling pubmed-24647652008-07-15 Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy Colombo, Giorgio L Caruggi, Mauro Ottolini, Chiara Maggioni, Aldo P Vasc Health Risk Manag Original Research Chronic heart failure (HF) is a major cause of morbidity and mortality particularly in the elderly and a growing healthcare burden in Italy. The objective was to assess the cost-effectiveness of candesartan cilexetil, an angiotensin II type 1 receptor blocker (ARB) for the treatment of HF. A pre-specified economic evaluation was conducted on resource utilization (cardiovascular drug treatment, cardiovascular and non-cardiovascular hospital admission, cardiovascular procedures/operations) prospectively collected alongside the CHARM program, a series of parallel randomized clinical trials comparing candesartan with placebo (standard therapy) in patients with NYHA Class II-IV HF: CHARM-Alternative (LVEF ≤40% patients not receiving ACE inhibitors because of previous intolerance); CHARM-Added (LVEF ≤40% patients currently receiving ACE inhibitors); or CHARM-Preserved (LVEF ≥40% patients). The primary outcome for the component trials was the composite of cardiovascular death or worsening hospital admission for HF and of the overall program all-cause mortality. Adjunctive treatment with candesartan in CHARM-Alternative and CHARM-Added led to clinical benefits and to either cost-savings or a small additional cost, depending on the trial. The less certain clinical benefit in CHARM-Preserved was obtained at modest extra cost. The incremental cost-effectiveness ratios (ICERs) were estimated to range from €713 per life year gained for CHARM-Alternative to dominant for CHARM-Added and the pooled reduced LVEF trials. Dove Medical Press 2008-02 /pmc/articles/PMC2464765/ /pubmed/18629370 Text en © 2008 Dove Medical Press Limited. All rights reserved
spellingShingle Original Research
Colombo, Giorgio L
Caruggi, Mauro
Ottolini, Chiara
Maggioni, Aldo P
Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy
title Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy
title_full Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy
title_fullStr Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy
title_full_unstemmed Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy
title_short Candesartan in heart failure: assessment of reduction in mortality and morbidity (CHARM) and resource utilization and costs in Italy
title_sort candesartan in heart failure: assessment of reduction in mortality and morbidity (charm) and resource utilization and costs in italy
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2464765/
https://www.ncbi.nlm.nih.gov/pubmed/18629370
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