TITLE

The economics of TRACE. A cost-effectiveness analysis of trandolapril in postinfarction patients with left ventricular dysfunction

AUTHOR(S)
LePen, C.; Lilliu, H.; Keller, T.; Fiessinger, S.
PUB. DATE
July 1998
SOURCE
PharmacoEconomics;1998, Vol. 14 Issue 1, p49
SOURCE TYPE
Academic Journal
DOC. TYPE
journal article
ABSTRACT
Objective: The objective of the study was to compute a cost-effectiveness ratio relating the economic cost of trandolapril to the number of effectiveness units (i.e. life-years) gained.Design and Setting: The trandolapril cardiac evaluation (TRACE) study was a prospective placebo-controlled clinical trial designed to determine the long term effect of the oral angiotensin-converting enzyme (ACE) inhibitor trandolapril in postinfarction patients with left ventricular dysfunction. We used the individual data of the TRACE trial to compute a cost-effectiveness ratio relating the economic cost of trandolapril to the number of life-years saved. The analysis was differential and was conducted from a payer perspective in a French setting. Costs were computed from individual data related to the use of resources during the TRACE trial. For drug treatments, we chose French public prices, and for hospitalisations, we used the mean cost as determined by the diagnosis related group (DRG) from the 1996 Programme de Médicalisation des Systémes d'Information (PMSI) database from the French Ministry of Health. Life expectancy was estimated through an accelerated failure-time model with an exponential distribution specification; we made the conservative hypothesis that the effect of trandolapril on mortality after the end of the trial was nil. We assessed the standard deviation and the 95% confidence interval (CI) of the ratio through its bootstrap distribution.Results: The incremental cost-effectiveness ratio of treating patients with trandolapril rather than with placebo was estimated as 4910 French francs (FF) per life-year saved. Discounting both costs and health effects led to ratio of FF6950 per life-year saved. The bootstrap estimate of the ratio reached FF5950 and the 95% CI was FF5650 to FF6250 per life-year saved.Conclusions: These results could be considered as highly cost effective, even though our estimation was very close to the design and the conditions of the TRACE trial. Nevertheless, we showed that this trial constitutes a favourable case for economic evaluation.
ACCESSION #
9526832

 

Related Articles

  • Trandolapril: An Update of its Pharmacology and Therapeutic Use in Cardiovascular Disorders. Peters, D.C.; Noble, S.; Plosker, G.L. // Drugs;Nov1998, Vol. 56 Issue 5, p871 

    Trandolapril is an orally administered angiotensin converting enzyme (ACE) inhibitor that has been used in the treatment of patients with hypertension and congestive heart failure (CHF), and after myocardial infarction (MI). Trandolapril is a nonsulfhydryl prodrug that is hydrolysed to the...

  • ACE inhibitor reduces the incidence of atrial fibrillation in post-myocardial infarction patients.  // Formulary;Oct99, Vol. 34 Issue 10, p877 

    Reports that angiotensin-converting enzyme (ACE) inhibitor therapy may prevent atrial fibrillation in post-myocardial infarction patients with left ventricular dysfunction. Analysis of the Trandolapril Cardiac Evaluation study; Number of patients involved in the double-blind evaluation; Factors...

  • New indication for ACE inhibitor.  // Drug Topics;7/21/97, Vol. 141 Issue 14, p7 

    Presents information on the use of Mavik (trandolapril) as maintenance therapy for patients with left ventricular dysfunction for heart failure after myocardial infarction (MI). Approval of the ACI inhibitor in 1996 for hypertension; Claims of the Knoll Pharmaceutical Company.

  • ACE inhibitor for LV dysfunction.  // Modern Medicine;Sep97, Vol. 65 Issue 9, p43 

    Reports that the drug trandolapril from Knoll Pharmaceutical Co. has been indicated as a maintenance therapy for patients with left ventricular dysfunction or heart failure after a heart attack. Dosage.

  • ACE inhibitor improves post-MI survival.  // Drug Store News;8/18/97, Vol. 19 Issue 13, pCP6 

    Announces that Knoll Pharmaceuticals' Mavik (trandolapril) has been cleared by the US Food and Drug Administration for marketing the acetylcholinesterase inhibitor as maintenance therapy for patients with left ventricular dysfunction or near failure after a heart attack.

  • MI patients with reduced LV function deserve ACE inhibitor therapy.  // Geriatrics;Apr96, Vol. 51 Issue 4, p62 

    Presents an abstract of the research report `A Clinical Trial of the Angiotensin-converting Enzyme Inhibitor Trandolapril in Patients With Left Ventricular Dysfunction After Myocardial Infarction,' by L. Keber, C. Torp-Pedersen, et al, as presented in a 1995 issue of the `New England Journal of...

  • MI patients with impaired LV function deserve ACE inhibitor therapy.  // Modern Medicine;May96, Vol. 64 Issue 5, p50 

    Presents an abstract of the article `A clinical trial of the angiotensin-converting enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction,' by L. Kober et al., published in `New England Journal of Medicine' on December 21, 1996.

  • Plasma and pericardial fluid natriuretic peptide levels in postinfarction ventricular dysfunction. Klemola, Rauli; Tikkanen, Ilkka; Vuolteenaho, Olli; Toivonen, Lauri; Laine, Mika // European Journal of Heart Failure;Jan2001, Vol. 3 Issue 1, p21 

    Aims:: In the present study we examined plasma and pericardial fluid ANP and BNP concentrations in postinfarction ventricular dysfunction. The association of peptide levels to left ventricular (LV) dysfunction and to the localization of the myocardial infarction (MI) was studied.

  • DO CHOLESTEROL LEVELS INFLUENCE LONG-TERM HEART FAILURE OUTCOME IN POST-INFARCT PATIENTS WITH MODERATE TO SEVERE LEFT VENTRICULAR SYSTOLIC DYSFUNCTION?  // Heart;Jul2008 Supp, Vol. 94, pA12 

    An abstract of the article "Do Cholesterol Levels Influence Long-term Heart Failure Outcome in Post-infarct Patients with Moderate to Severe Left Ventricular Systolic Dysfunction?" by R. Sankaranarayanan, M.A. James, H. Gonna, S. Burtchaell and R. Holloway is presented.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics