{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T02:37:54Z","timestamp":1794623874326,"version":"4.9.1"},"reference-count":29,"publisher":"BMJ","issue":"21","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Heart"],"accepted":{"date-parts":[[2014,6,3]]},"published-print":{"date-parts":[[2014,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>In the Eplerenone in Mild Patients Hospitalization and Survival Study in Heart Failure (EMPHASIS-HF), aldosterone blockade with eplerenone decreased mortality and hospitalisation in patients with mild symptoms (New York Heart Association class II) and chronic systolic heart failure (HF). The present study evaluated the cost-effectiveness of eplerenone in the treatment of these patients in the UK and Spain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Results from the EMPHASIS-HF trial were used to develop a discrete-event simulation model estimating lifetime direct costs and effects (life years and quality-adjusted life years (QALYs) gained) of the addition of eplerenone to standard care among patients with chronic systolic HF and mild symptoms. Eplerenone plus standard care compared with standard care alone increased lifetime direct costs per patient by \u00a34284 for the UK and \u20ac7358 for Spain, with additional quality-adjusted life expectancy of 1.22 QALYs for the UK and 1.33 QALYs for Spain. Mean lifetime costs were \u00a33520 per QALY in the UK and \u20ac5532 per QALY in Spain. Probabilistic sensitivity analysis suggested a 100% likelihood of eplerenone being regarded as cost-effective at a willingness-to-pay threshold of \u00a320\u2005000 per QALY (UK) or \u20ac30\u2005000 per QALY (Spain).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>By currently accepted standards of value for money, the addition of eplerenone to optimal medical therapy for patients with chronic systolic HF and mild symptoms is likely to be cost-effective.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/heartjnl-2014-305673","type":"journal-article","created":{"date-parts":[[2014,7,3]],"date-time":"2014-07-03T22:34:10Z","timestamp":1404426850000},"page":"1681-1687","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Cost-effectiveness of eplerenone in patients with systolic heart failure and mild symptoms"],"prefix":"10.1136","volume":"100","author":[{"given":"Dawn","family":"Lee","sequence":"first","affiliation":[{"name":"BresMed, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koo","family":"Wilson","sequence":"additional","affiliation":[{"name":"Health Economic and Outcomes Research, Pfizer Ltd, Surrey, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron","family":"Akehurst","sequence":"additional","affiliation":[{"name":"BresMed, Sheffield, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin R","family":"Cowie","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Imperial College (Royal Brompton Hospital) London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"CHU and Department of Cardiology, Inserm, Centre d'Investigation Clinique CIC 9501 and U961, Nancy University, Nancy, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Krum","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Preventive Medicine, Centre of Cardiovascular Research and Education in Therapeutics, Monash University, Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk J","family":"van Veldhuisen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thorax Centre, University Medical Centre, Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Vincent","sequence":"additional","affiliation":[{"name":"Pfizer, Inc., New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertram","family":"Pitt","sequence":"additional","affiliation":[{"name":"University of Michigan School of Medicine, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J V","family":"McMurray","sequence":"additional","affiliation":[{"name":"The British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2014,7,3]]},"reference":[{"key":"2025092000050700000_100.21.1681.1","unstructured":"National Institute for Cardiovascular Outcomes Research. National heart failure audit: April 2010\u2014march 2011. http:\/\/www.ucl.ac.uk\/nicor\/audits\/heartfailure\/ (accessed 1 May 2013)."},{"key":"2025092000050700000_100.21.1681.2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2003.025270"},{"key":"2025092000050700000_100.21.1681.3","doi-asserted-by":"publisher","DOI":"10.1136\/heart.83.5.505"},{"key":"2025092000050700000_100.21.1681.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-9842(00)00141-0"},{"key":"2025092000050700000_100.21.1681.5","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs104"},{"key":"2025092000050700000_100.21.1681.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909023411001"},{"key":"2025092000050700000_100.21.1681.7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009492"},{"key":"2025092000050700000_100.21.1681.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030207"},{"key":"2025092000050700000_100.21.1681.9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2010.00775.x"},{"key":"2025092000050700000_100.21.1681.10","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfs067"},{"key":"2025092000050700000_100.21.1681.11","doi-asserted-by":"crossref","first-page":"iii","DOI":"10.3310\/hta11470","article-title":"The clinical effectiveness and cost-effectiveness of cardiac resynchronisation (biventricular pacing) for heart failure: Systematic review and economic model","volume":"11","author":"Fox","year":"2007","journal-title":"Health Technol Assess"},{"key":"2025092000050700000_100.21.1681.12","doi-asserted-by":"crossref","unstructured":"Harrell F . Regression modeling strategies: With applications to linear models, logistic regression, and survival analysis. Springer, 2001.","DOI":"10.1007\/978-1-4757-3462-1"},{"key":"2025092000050700000_100.21.1681.13","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.110536"},{"key":"2025092000050700000_100.21.1681.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2008.00425.x"},{"key":"2025092000050700000_100.21.1681.15","first-page":"91","article-title":"The cost effectiveness of enalapril in the treatment of chronic heart failure","volume":"6","author":"Hart","year":"1993","journal-title":"Br J Med Econ"},{"key":"2025092000050700000_100.21.1681.16","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehl016"},{"key":"2025092000050700000_100.21.1681.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2004.12.003"},{"key":"2025092000050700000_100.21.1681.18","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2532"},{"key":"2025092000050700000_100.21.1681.19","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X11401031"},{"key":"2025092000050700000_100.21.1681.20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.310"},{"key":"2025092000050700000_100.21.1681.21","doi-asserted-by":"publisher","DOI":"10.1016\/S1388-9842(01)00198-2"},{"key":"2025092000050700000_100.21.1681.22","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2001.3114"},{"key":"2025092000050700000_100.21.1681.23","unstructured":"Joint Formulary Committee. British National Formulary 62. London: BMJ Group and Pharmaceutical Press. http:\/\/www.medicinescomplete.com (accessed 1 May 2013)."},{"key":"2025092000050700000_100.21.1681.24","unstructured":"Cataolgo de especialidades farmaceuticas. Madrid: Consejo General de Colegios Oficiales de Farmaceuticos, 2011."},{"key":"2025092000050700000_100.21.1681.25","unstructured":"Oblikue Consulting. Base de conocimiento de costes y precios del sector sanitario. http:\/\/oblikue.com\/bddcostes\/ (accessed September 2011)."},{"key":"2025092000050700000_100.21.1681.26","unstructured":"Curtis L . Unit costs of health and social care 2011. http:\/\/www.pssru.ac.uk\/pdf\/uc\/uc2011\/uc2011.pdf (accessed 1 May 2013)."},{"key":"2025092000050700000_100.21.1681.27","unstructured":"Scotland ISD. 2010\/11 scottish tariffs for cross boundary flow costing. http:\/\/www.isdscotland.org\/Health-Topics\/Finance\/Scottish-National-Tariff\/1011ScotTariffs.xls?76638430357-2011-05-09 (accessed 1 May 2013)."},{"key":"2025092000050700000_100.21.1681.28","doi-asserted-by":"publisher","DOI":"10.1007\/s11136-010-9591-y"},{"key":"2025092000050700000_100.21.1681.29","unstructured":"Mowatt G Vale L Perez J . Systematic review of the effectiveness and cost-effectiveness of home versus hospital or satellite unit haemodialysis for people with end stage renal failure. (accessed 1 May 2013)."}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/heartjnl-2014-305673","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T07:05:13Z","timestamp":1758351913000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/heartjnl-2014-305673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7,3]]},"references-count":29,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2014,10,11]]},"published-print":{"date-parts":[[2014,11,1]]}},"alternative-id":["10.1136\/heartjnl-2014-305673"],"URL":"https:\/\/doi.org\/10.1136\/heartjnl-2014-305673","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7,3]]}}}