Abstract 9811: Medical Resource Use, Costs and Quality of Life are Similar Between Patients with Acute Decompensated Heart Failure Treated with Nesiritide Versus Placebo
Introduction: In the recent Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure Trial (ASCEND-HF), treatment with nesiritide did not reduce heart failure rehospitalization or mortality at 30 days relative to treatment with placebo. Dyspnea was marginally improved with nesiritide, but did not reach pre-specified levels for statistical significance. Our study reports on a prospective economic and quality of life evaluation that was conducted as part of the trial.
Objective: Compare medical resource use, costs and quality of life outcomes between patients randomized to nesiritide versus placebo in the ASCEND-HF.
Methods: Detailed resource use data, including data on length of stay and readmissions within 30 days were collected on the case report form. Quality of life was assessed using the EQ-5D, administered at baseline, 24 hours, discharge, and 30 days. Hospital billing data representing 1253 admissions for US patients were used to develop a cost prediction model (R2=0.70), which was used to generate inpatient cost estimates for patients without billing data (US and non-US). To lessen the influence of geographical variations in length of stay when estimating costs, we applied an adjustment in which length of stay was reweighted based on the mean LOS in the US relative to each country. Generalized linear models were used to compare resource use and costs. Responses to the EQ-5D were converted to US utility weights. Patients who died were assigned an EQ-5D value of 0. ANOVA was used to compare EQ-5D utilities between treatment groups.
Results: Of 7141 patients randomized, 7007 received study drug. Estimates of resource use, direct medical costs and EQ-5D utility weights are reported in the Table.
Conclusions: Consistent with main study findings, measures of medical resource use, costs, and EQ-5D health utilities were similar between nesiritide and placebo in this trial.
- © 2011 by American Heart Association, Inc.