Utilities and medication and event costs used within the model
| Parameter | Input value—UK model | Input value—Spanish model | Reference |
|---|---|---|---|
| Per annum treatment costs | |||
| Eplerenone drug costs | £557 | €1086 | 23 24 |
| Standard care drug costs | £0 | €0 | Assumed |
| Concomitant medications | £229 | €290 | 23 24 |
| Eplerenone treatment initiation (one-off)* | £463 | €119 | 25–27 |
| Disease management and monitoring | £443 | €60 | 25–27 |
| Event-based costs | |||
| HF hospitalisation | £3463 | €3321 | 25 27 |
| Other CV hospitalisation | £3001 | €4980 | 25 27 |
| Adverse event—eplerenone† | £237 | €786 | 25 27 |
| Adverse event—standard care† | £280 | €1133 | 25 27 |
| Cost of CRT and ICD devices | £5842 | €9005 | 25 27 |
| Average CRT and ICD device life | 5.8 years | 5.8 years | 11 |
| Quality-of-life utilities | |||
| Baseline utility | 0.84 | 0.84 | 14 |
| Utility decrement for patients who experience one hospitalisation | −0.024 | −0.024 | 14 |
| Utility decrement for patients who experience two hospitalisations | −0.031 | −0.031 | 14 |
| Utility decrement for patients who experience three hospitalisations | −0.055 | −0.055 | 14 |
| Utility decrement for new-onset atrial fibrillation | −0.084 | −0.084 | 28 |
| Lifetime utility decrement for adverse events—eplerenone | −0.0003 | −0.0003 | 19 |
| Lifetime utility decrement for adverse events—standard care | −0.0001 | −0.0001 | 19 |
| Short-term utility decrement for adverse events—eplerenone‡ | −0.0012 | −0.0012 | 19 29 |
| Short-term utility decrement for adverse events—standard care‡ | −0.0008 | −0.0008 | 19 |
*Two hospital appointments with a consultant and two sets of blood chemistry tests.
†The unit costs of the adverse events for each of the five events modelled for the two arms were assumed to be the same. The proportion of patients experiencing each type of event (hospitalised and non-hospitalised) was calculated using the trial results. Costs are higher on the placebo arm as more patients were hospitalised (23% of adverse events vs 15%) and more patients experienced renal failure which is the most costly of the five key adverse events included.
‡Applied for 21 days based upon clinician advice.
CRT, cardiac resynchronisation therapy; CV, cardiovascular; HF, heart failure; ICD, implantable cardioverter-defibrillator.