Cost-effectiveness analysis of long-term moderate exercise training in chronic heart failure☆
Section snippets
Methods
To determine the cost-effectiveness of a 14-month-long moderate ET in heart failure, published results from a recent randomized controlled clinical trial were used.1 A standard cost-effectiveness analysis was performed11 and the cost-effectiveness ratio, expressed in dollars per year of life saved, was calculated. A discount rate of 3% was selected and applied to costs and consequences to address subjects’ time preference for the future costs and benefits.11 In our analysis, costs referred to
Incremental cost of exercise program
In the randomized trial, the hospitalization rate during the follow-up period was 29% in the control group (there were 14 admissions in the control group consisting of 49 patients) and 10% in the exercise group (only 5 of 50 patients in the training group were admitted). Assuming that the hospitalization rates for the training and the control groups were identical after the follow-up period, a reduction of 19%, simply the difference between the 2 groups in hospitalization rate, was obtained for
Discussion
Because the present findings have no precedence in the current literature, no direct comparison could be established with other cost-effectiveness values. However, reference can be made to a familiar categorization scheme19 in which a cost-effectiveness value of ≤$20,000 indicates a highly cost-effective intervention, a value of $20,000 to $40,000 describes consistency with currently funded interventions, and a value >$40,000 indicates marginal or poor cost-effectiveness. On this basis,
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2016, Hellenic Journal of CardiologyCitation Excerpt :longer warm-up and recovery periods are necessary.36,47 The future roles and FOC of PRM specialists will be the promotion, coordination and implementation of randomized controlled trials that include cohorts receiving contemporary CR services, and comprehensive cost-effectiveness analyses of CR services.5,6–11,12 These types of trial should produce new findings and data for updating the contemporary state of CR services.
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2015, Cardiac Electrophysiology ClinicsCitation Excerpt :To qualify for coverage, patients should not have had recent (≤6 weeks) or planned (≤6 months) major cardiovascular hospitalizations or procedures. Exercise training has been shown to be very cost-effective compared with other therapies.33 Palliative care is widely misunderstood to represent only end-of-life care.
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This study was supported in part by a grant from the Joseph L. Mailman School of Public Health, Division of Health Policy and Management, Columbia University, New York, New York and Merck & Co., Inc., West Point, Pennsylvania. Manuscript received August 16, 2000; revised manuscript received and accepted October 30, 2000.