Clinico-economic evaluation of complex cardiovascular therapy with magnesium orotate in patients with chronic heart failure versus standard therapy in Ukraine

Abstract

OBJECTIVES: To evaluate the profitability of the complex cardiovascular therapy with magnesium orotate in patients with chronic heart failure (CHF) IV functional class (NYHA IV). METHODS: Cost-effectiveness evaluation of 2 treatment strategies was performed using the modeling decision tree . Data from various sources: the results of two clinical trials (Stepura O.B., Martynow A.I., 2009; Libis R.A. et al, 1999) and National standard of treatment of patients with CHF FC IV were used in the modeling. Cost-effectiveness ratio was evaluated in accordance with the threshold willingness to pay for improving health achievement. The analysis of the impact of the investigated treatment strategies on the budget, taking into account the lost productivity was conducted. RESULTS: The inclusion of magnesium orotate in the CHF standard therapy improves the health (NNT was 1 / 0, 24 4), it gives an additional 0,14 QALYs and requires additional costs. Only direct medical costs were included in the cost value. Incremental cost-effectiveness ratio was 1517,82 $ / add. QALY. It is less than GDP per capita (current threshold willingness to pay), i.e. cardiovascular therapy with magnesium orotate is cost effective. However, taking into account the financial capacity of the health system in Ukraine, in real practice such costs for achieve better health are less acceptable than the costs of standard therapy. Indirect costs (lost productivity) during 2 years in the application of standard therapy with magnesium orotate were less than indirect costs in application only standard therapy. Saving money - 606,7 $ per patient. CONCLUSIONS: Thus the inclusion of magnesium orotate in the standard therapy in patients with CHF is cost effective. High direct costs are compensated due in indirect costs savings.