A Cost-Minimisation Analysis of Cardiac Failure Treatment in the UK Using CIBIS Trial Data

The clinical benefits of beta-blockers in heart failure are currently subject to intense debate and are being investigated. The economic impact of beta-blockade, however, has largely remained unexplored, The Cardiac Insufficiency Bisoprolol Study (CIBIS), while failing to show statistically significant reduction in mortality over conventional therapy, demonstrates that the administration of bisoprolol adjuvant to standard therapy leads to a significant reduction in hospital admission. The present study is a cost minimisation analysis based on CIBIS data for the UK and is restricted to direct costs only. The costs of bisoprolol medication and inpatient treatment of heart failure are considered. The 'base case' analysis and the sensitivity analyses carried on all cost driver parameters show that administering bisoprolol to heart failure patients adjuvantly to the standard therapy is at least cost neutral. Additional drug costs incurred by bisoprolol are compensated by the inpatient treatment costs of heart failure avoided. All other non-quantifiable clinical benefits such as improvement of New York Heart Association functional class are positive extras to patients and the National Health Service.