IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v29y2009i3p325-333.html
   My bibliography  Save this article

Long-Term Cost-Effectiveness of Disease Management in Systolic Heart Failure

Author

Listed:
  • George Miller

    (Altarum Institute, Ann Arbor, MI, george.miller@altarum.org)

  • Stephen Randolph

    (Altarum Institute, San Antonio, TX)

  • Emma Forkner

    (South Carolina Department of Health and Human Services, Columbia)

  • Brad Smith

    (Altarum Institute, San Antonio, TX)

  • Autumn Dawn Galbreath

    (University of Texas Health Science Center at San Antonio, San Antonio)

Abstract

Background. Although congestive heart failure (CHF) is a primary target for disease management programs, previous studies have generated mixed results regarding the effectiveness and cost savings of disease management when applied to CHF. Objective. We estimated the long-term impact of systolic heart failure disease management from the results of an 18-month clinical trial. Methods. We used data generated from the trial (starting population distributions, resource utilization, mortality rates, and transition probabilities) in a Markov model to project results of continuing the disease management program for the patients' lifetimes. Outputs included distribution of illness severity, mortality, resource consumption, and the cost of resources consumed. Both cost and effectiveness were discounted at a rate of 3% per year. Cost-effectiveness was computed as cost per quality-adjusted life year (QALY) gained. Results. Model results were validated against trial data and indicated that, over their lifetimes, patients experienced a lifespan extension of 51 days. Combined discounted lifetime program and medical costs were $4850 higher in the disease management group than the control group, but the program had a favorable long-term discounted cost-effectiveness of $43,650/QALY. These results are robust to assumptions regarding mortality rates, the impact of aging on the cost of care, the discount rate, utility values, and the targeted population. Conclusions. Estimation of the clinical benefits and financial burden of disease management can be enhanced by model-based analyses to project costs and effectiveness. Our results suggest that disease management of heart failure patients can be cost-effective over the long term.

Suggested Citation

  • George Miller & Stephen Randolph & Emma Forkner & Brad Smith & Autumn Dawn Galbreath, 2009. "Long-Term Cost-Effectiveness of Disease Management in Systolic Heart Failure," Medical Decision Making, , vol. 29(3), pages 325-333, May.
    • Handle: RePEc:sae:medema:v:29:y:2009:i:3:p:325-333
    DOI: 10.1177/0272989X08327494
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X08327494
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X08327494?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    2. F. Tomini & F. Prinzen & A. D. I. Asselt, 2016. "A review of economic evaluation models for cardiac resynchronization therapy with implantable cardioverter defibrillators in patients with heart failure," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(9), pages 1159-1172, December.
    3. de Bruin, Simone R. & Heijink, Richard & Lemmens, Lidwien C. & Struijs, Jeroen N. & Baan, Caroline A., 2011. "Impact of disease management programs on healthcare expenditures for patients with diabetes, depression, heart failure or chronic obstructive pulmonary disease: A systematic review of the literature," Health Policy, Elsevier, vol. 101(2), pages 105-121, July.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:29:y:2009:i:3:p:325-333. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.