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New study estimates potential savings gained by expanding use of beta-blockers in heart failure patients

Using a decision model, researchers estimate that Medicare costs would decrease if the use of beta-blocker drugs were more widespread, according to a new study sponsored by the Agency for Healthcare Research and Quality (AHRQ grant HS10548) and published in the January 2004 issue of the American Journal of Medicine.

Although numerous clinical trials have demonstrated the effectiveness of beta-blockers in reducing hospitalizations and deaths from heart failure, recent studies suggest that beta-blocker use in the heart failure population remains at less-than-optimal levels. Heart failure occurs when the heart loses its ability to pump enough blood through the body. Beta-blockers can improve heart function and prolong survival in patients with heart failure.

Researchers from the AHRQ-sponsored Duke Center for Education and Research on Therapeutics (CERTs) estimate that treatment for heart failure without beta-blocker drugs would cost Medicare $39,739 per patient over a 5-year period. Treatment with beta-blockers, on the other hand, would cost an estimated $33,675, a per-patient savings of $6,064. In contrast, beta-blocker therapy would increase expenses to Medicare patients by an estimated $2,113 over 5 years.

Although at the time of the study Medicare did not cover prescription drugs, researchers estimated that program savings would remain positive even if Medicare reimbursed patients for the cost of beta-blockers.

Estimates in the study were calculated using a Markov decision model. Calculations were based on clinical trial data on rates of hospitalization/death and effectiveness of beta-blockers, Duke University Medical Center estimates of hospital costs and reimbursement, and physician fees from the Medicare fee schedule.

For more details, see "Economic effects of beta-blocker therapy in patients with heart failure," by Patricia A. Cowper, Ph.D., Elizabeth R. DeLong, Ph.D., David J. Whellan, M.D., and others in the January 15, 2004, American Journal of Medicine 116(2), pp. 104-111.

Editor's Note: AHRQ's Centers for Education and Research on Therapeutics (CERTs) program is a national initiative to increase awareness of the benefits and risks of new, existing, or combined uses of therapeutics, through education and research.

The seven CERTs are: Duke University Medical Center, the HMO Research Network, University of Alabama at Birmingham, University of Arizona Health Sciences Center, University of North Carolina, University of Pennsylvania, and Vanderbilt University Medical Center.

More information on the CERTs and their activities is available at www.certs.hhs.gov.

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