Heart failure & cardiomyopathies
Cost-effectiveness and budget-impact analysis of Acetazolamide in decompensated heart failure patients with volume overload in the German health care system
Authors' conclusion
Acetazolamide appears to be a cost-effective and potentially cost-saving adjunct to standard care in patients hospitalized with ADHF in Germany. Broad adoption of acetazolamide could reduce inpatient costs for ADHF, with potential annual savings ranging from tens to hundreds of millions of euros depending on eligibility and uptake.
Study context
- Population
- Hospitalized acute decompensated heart failure (ADHF) patients in the German health care system, based on data from the ADVOR trial
- Comparison
- The addition of acetazolamide to standard diuretic therapy in hospitalized ADHF patients
- Outcome
- Cost per patient and QALYs (base-case analysis)
- Follow-up
- 3 months
Methodological details3-month time horizon, perspective of the German statutory health insurance (GKV), deterministic and probabilistic sensitivity analyses, complementary budget impact analysis (BIA)
- 3-month time horizon
- Perspective of the German statutory health insurance (GKV)
- Deterministic and probabilistic sensitivity analyses
- Complementary budget impact analysis (BIA)
Main finding
As reported in the abstract
QALY difference
0.00458
≈ 1.7 quality-adjusted days over 3 months; higher with acetazolamide
ICER
−101 449€ per QALY
acetazolamide technically dominant
Acetazolamide
- Cost per patient
- 4495€
- QALYs
- 0.132287
Standard diuretic therapy
- Cost per patient
- 4959€
- QALYs
- 0.127710
Cost per patient
QALYs
Further findings
Scenario using arm-specific outcomes from ADVOR
- QALY decrement
- −0.00024
- Acetazolamide remained cost-saving
Budget impact analysis: annual savings
- Annual savings depending on uptake and patient eligibility
- €11-217 million
- Full uptake when ADVOR exclusion criteria are applied
- €39 million
Original publication
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