Incremental cost-effectiveness ratios were estimated at $58 409 and $35 600 per QALY gained for the full cohort and in patients with preserved ejection fraction, respectively.Ĭonclusions and Relevance These analyses suggest that longer-term benefits of this novel rehabilitation intervention, particularly in the subgroup of patients with preserved ejection fraction, may yield good value to the health care system. Quality of life gains were significantly greater in the intervention vs control group during 6 months (mean utility difference, 0.074 P = .001) and sustained beyond the 12-week intervention. The mean (SD) cost of the intervention was $4204 ($2059). Results Among the 349 patients included in the analysis (183 women mean age, 72.7 years 176 non-White and 173 White ), mean (SD) cumulative costs per patient were $26 421 ($38 955) in the intervention group (excluding intervention costs) and $27 650 ($30 712) in the control group (difference, −$1229 95% CI, −$8159 to $6394 P = .80). Main Outcomes and Measures Costs, quality-adjusted life-years (QALYs), and the lifetime estimated cost per QALY gained (incremental cost-effectiveness ratio). Interventions Rehabilitation intervention or control. Data were analyzed from March 24, 2019, to December 1, 2020.
#Pcad 2006 reports trial#
Cost-effectiveness was estimated using the validated Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, which uses an individual-patient simulation model informed by the prospectively collected trial data.
Medical resource use and medication costs were estimated using 2019 US Medicare payments and the Federal Supply Schedule, respectively. For this preplanned secondary analysis of the economic outcomes, data on medical resource use and quality of life (via the 5-level EuroQol 5-Dimension scores converted to health utilities) were collected. Objective To report the economic outcomes of the REHAB-HF trial and estimate the potential cost-effectiveness of the intervention.ĭesign, Setting, Participants The multicenter REHAB-HF trial randomized 349 patients 60 years or older who were hospitalized for acute decompensated heart failure to rehabilitation intervention or a control group patients were enrolled from September 17, 2014, through September 19, 2019. The economic implications of these results are important given the increasing pressures for cost containment in health care. Importance In the Rehabilitation Therapy in Older Acute Heart Failure Patients (REHAB-HF) trial, a novel 12-week rehabilitation intervention demonstrated significant improvements in validated measures of physical function, quality of life, and depression, but no significant reductions in rehospitalizations or mortality compared with a control condition during the 6-month follow up.
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