Economic implications of the Total Ischaemic Burden Bisoprolol Study (TIBBS) follow-up

Abstract

Data from the TIBBS follow-up and published costs were combined in an economic analysis of stable angina patients, classified into subgroups defined by number of episodes of transient ischaemia detected on 48-hour ECG (<2, 2 to 6, >6 episodes); response to therapy (100% or non-100% responders); and initial therapy received in the randomised period of TIBBS (bisoprolol or nifedipine). The mean costs per patient over 12 months were: £766, £1481, and £1914 for <2, 2 to 6, and >6 episodes respectively; £1082 and £1938 for 100% responders and non-100% responders respectively; £1372 and £2030 for patients receiving bisoprolol or nifedipine respectively. Higher frequency of ischaemic episodes on ambulant ECG predict increased costs over the following 12 months. Failure to respond to therapy for transient ischaemia may identify patients that have increased costs. Treatment of transient ischaemia with bisoprolol in stable angina patients results in reduced long-term cardiovascular events and decreased total costs in comparison to treatment with nifedipine.

Keywords: :

• stable angina
• costs
• cost-effectiveness
• bisoprolol
• nifedipine
• decision analysis
• modelling