Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (4): 91-98.doi: 10.6040/j.issn.1671-7554.0.2021.1451

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Pharmacoeconomic evaluation of levosimendan and milrinone in the treatment of 711 patients with severe heart failure complicated with renal injury

DONG Xue1,2,3, ZHAO Xia4, CHENG Zijie5, HAN Yi4   

  1. 1. Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, Shandong, China;
    3. Department of Education, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China;
    4. Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Shandong Medicine and Health Key Laboratory of Clinical Pharmacy, Jinan 250014, Shandong, China;
    5. Department of Clinical Pharmacy, School of Basic Medicine, China Pharmaceutical University, Nanjing 210009, Jiangsu, China
  • Published:2022-04-22

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Abstract: Objective To investigate the cost-effectiveness differences between levosimendan and milrinone in treating severe heart failure complicated with normal, mild and moderate impaired renal function. Methods A total of 711 patients hospitalized in the Cardiology Department of Shandong Provincial Qianfoshan Hospital due to severe heart failure during Dec. 2016 and Sep. 2019 were enrolled. According to the renal function, the patients were divided into moderate renal injury group(n=299)and normal renal function or mild renal injury group(n=412), and then divided into levosimendan subgroup and milrinone subgroup. The information and clinical outcomes of patients 30 days after drug use were collected through the electronic medical record system and follow-up visits. With “obvious efficiency” with no adverse clinical events, and “efficiency” with no death within 30 days as effectiveness indexes, and the discount adjusted total hospitalization cost as the cost index, a decision tree analysis model was constructed, and cost-effectiveness analysis and one-way sensitivity analysis were performed. Results In the moderate renal injury group, with “obvious efficiency” as the effectiveness index, milrinone had absolute pharmacoeconomic advantages; with “efficiency” as the effectiveness index, each 1% more efficiency of levosimendan costed ￥4 562.64 more than that of milrinone. In the normal renal function or mild renal injury group, the total hospitalization cost of levosimendan was lower than that of milrinone, and each 1% increase in obvious efficiency of milrinone costed ￥400.89 more than that of levosimendan, and each 1% increase in efficiency of milrinone costed ￥1 751.16 more than that of levosimendan. The sensitivity analysis results were robust. Conclusion Based on real-world data, milrinone has an economic advantage over levosimendan in severe heart failure patients with moderate renal injury. For patients with normal renal function or mild renal injury, levosimendan has a moderate economic advantage over milrinone.

Key words: Severe heart failure, Levosimendan, Milrinone, Cost-effectiveness analysis, Decision tree model, Pharmacoeconomics

CLC Number: 

  • R956
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