One-year cost-effectiveness of supervised center-based exercise training in addition to a post-discharge disease management program for patients recently hospitalized with acute heart failure: The EJECTION-HF study

Abstract

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.

Keywords: Cost effectiveness; Disease management; Exercise training; Heart failure; Net monetary benefit.