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One-year cost-effectiveness of supervised centre-based exercise training in addition to a post-discharge disease management program for patients recently hospitalized with acute heart failure: the EJECTION-HF study
Maru S, Mudge AM, Suna JM, Scuffham PA, on behalf of the EJECTION-HF Trial Investigators
Heart & Lung 2019 Sep-Oct;48(5):414-420
clinical trial
2/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Combining supervised exercise training (ET) and disease management program (DMP) may benefit people with heart failure (HF) but will require additional resources. OBJECTIVES: To assess the 1-year cost-effectiveness of a 24-week ET program added to a post-discharge DMP in patients recently hospitalized with HF. METHODS: Using randomized controlled trial data, within-trial cost-utility analyses were undertaken in the overall population (n = 278), patients aged < 70 (n = 180), and those aged >= 70 (n = 98). Incremental net monetary benefits (INMB) were calculated based on quality-adjusted life-years (QALY) and healthcare costs from the perspective of a state health department (Queensland, Australia). RESULTS: At the AU$50,000/QALY threshold, ET showed 29.6% and 1.7% probability of being cost-effective in the overall population (INMB AU$ -1,472) and patients aged >= 70 (INMB AU$ -11,469), respectively. In patients aged < 70, ET was potentially cost-effective with 83.6% probability (INMB AU$4,059). CONCLUSION: Adding ET to DMP was not cost-effective overall or in patients aged >= 70 but was relatively cost-effective in those aged < 70.

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