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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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Formato: | Texto |
Lenguaje: | English |
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Dove Medical Press
2008
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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. |
format | Text |
id | pubmed-2464765 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2008 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
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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