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Combo Therapy Helps Black Heart Failure Patients

Reduction in hospitalizations also boosts cost savings

WEDNESDAY, Dec. 14 (HealthDay News) -- In black patients with heart failure, fixed-dose combination therapy using isosorbide dinitrate/hydralazine (ISDN/HYD) not only improves outcomes but also reduces the overall cost of care, according to a study published online Dec. 12 in Circulation: Journal of the American Heart Association.

Derek Angus, M.D., MPH, of the University of Pittsburgh, and colleagues studied data from the African-American Heart Failure Trial (A-HeFT) in which 1,050 subjects from 169 sites were randomly assigned to receive ISDN/HYD or a placebo.

Those in the ISDN/HYD group had a 33% chance of heart failure-related hospitalization versus 47% for the placebo group, which also had a longer mean length of hospital stay (7.9 days versus 6.7 days for the ISDN/HYD group). Excluding the cost of the drugs, the mean per-subject costs related to heart failure were $9,144 for the placebo group and $5,997 for the ISDN/HYD group. Total health care costs were $19,728 and $15,384 for the placebo and ISDN/HYD groups, respectively.

"We found that use of ISDN/HYD therapy in A-HeFT led to fewer hospitalizations, shorter hospitalizations and consequently lower health care costs," the authors conclude. "Even extending to a projected lifetime horizon under the conservative assumption that there would be no benefit beyond the trial, this therapy provided a reference case cost-effectiveness that is still very favorable."

The study was funded by NitroMed, Inc. of Lexington, Mass.

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