657 Abstracts PCV37 THE ADDITIONAL TREATMENT OF PATIENTS WITH CHRONIC HEART FAILURE WITH METOPROLOL CR/XL WILL LEAD TO COST SAVINGS IN THE GERMAN HEALTH CARE SYSTEM Pirk O 1 , Schoeffski O 2 1 Fricke & Pirk GmbH, Nuremberg, Germany; 2 University Erlangen-Nuremberg, Nuremberg, Germany OBJECTIVE: Chronic heart failure (CHF) is a disease with a poor prognosis leading to incapacitating symptoms with recurrent hospital admissions. The MEtoprolol CR/XL Randomized Intervention Trial in congestive Heart Failure (MERIT-HF) was terminated early due to the decrease in mortality in the patient group receiving additional to standard treatment Metoprol CR/XL (MET). The aim of the presented study is to show the eco- nomic besides the clinical benefit. METHODS: A cost benefit approach was used based on published data of hospitalisation days from the multicentre randomized double-blind placebo-controlled MERIT-HF and on the additional drug costs as calculated based on the trial. The calculation was done from the German payers’ perspec- tive, only direct costs were taken into account. Data on drug costs were derived from the Ifap-Index (2003), dis- counts from retail pharmacists, whole salers manufac- turers and patients’ co-payments were taken into consideration. Daily bed charges for hospital stay were taken from the database of German private health insur- ers. Two scenarios were calculated. First it was assumed that no patient stayed in an intensive care unit (ICU). Second it was assumed each patient admitted to a hospi- tal stayed at least one day in an ICU. RESULTS: In the MET-group (1990 patients) a decrease of 2090 hospital- isation days was seen compared to the placebo-group (2001). The adjusted costs for the prevented hospital stays were €499,555 (normal ward) or €558,109 (addi- tional ICU). According to MERIT HF additional treat- ment costs are €524,782 maximum. This result is highly sensitive to the mean duration of treatment. If the “real- istic” treatment duration is only 5% (26 days) below the maximum of 521 days the costs will be €474,621 and offset the hospitalisation costs. CONCLUSION: The presented data were calculated conservatively but prove that the clinical benefit is mirrored by the economic results for the German health care system. Nevertheless, further analysis on the detailed MERIT-HF data is needed. PCV38 COST-EFFECTIVENESS OF TREATING BY SIMVASTATIN 40 MG/DAY HIGH VASCULAR RISK PATIENTS:AN ECONOMIC EVALUATION BASED ON THE HEART PROTECTION STUDY Fagnani F 1 , Lafuma A 1 , Souchet T 2 1 CEMKA, Bourg la Reine, France; 2 Merck Sharp & Dohme— Chibret, Paris, France OBJECTIVES: Estimate the cost-effectiveness ratio of treating high vascular risk patients with simvastatin in France. METHODS: Data were extracted from the pub- lished results of the MRC/BHF Heart Protection Study (HPS) performed in UK. HPS compared the occurrence of total and CHD deaths, major vascular events (MVE), and major coronary events (MCE) in more than 20,000 high vascular risk patients (patients with diabetes, prior stroke or other cerebrovascular disease, peripheral arterial disease, or with CHD). Patients were randomly assigned to simvastatin (40 mg/day) or placebo and fol- lowed at least for 5 years. The cost-effectiveness analysis was performed using French unit costs. Direct costs included the extra costs of simvastatin and the benefit associated with avoided vascular events. Indirect costs were not considered. Costs and benefit were discounted at 5%. RESULTS: All-cause mortality was reduced by 13% (RR = 0.87, p = 0.0003). There was a discounted survival benefit of 0.040 year per included patient. There were highly significant reductions of about one quarter in the risk of first event rate of MVE (RR = 0.76, p < 0.0001) and of MCE (RR = 0.73, p = 0.0001). The absolute reduc- tion of events during the 5-year period in the simvastatin group was 5.4% for any major vascular event, 2.1% for non fatal MI, 1.3% for non fatal stroke, 2.4 % for revas- cularisation, 1.2% for fatal MI and 0.2% for fatal stroke. The discounted extra cost of simvastatin was estimated at €1994 ($1 = €1) taking into account the statins in the placebo group. This cost was reduced to €1031 by con- sidering the direct cost associated with avoided vascular events. Cost-effectiveness ratio was then estimated at €25,517 per life year gained (€22,000 to €50,000 in the different patients subcategories, ratios well accepted as being cost-effective). CONCLUSION: Treatment with simvastatin in different subcategories of high vascular risk patients is cost-effective in the French setting. PCV39 ECONOMIC EVALUATION OF THE MEDENOX (PROPHYLAXIS IN MEDICAL PATIENTS WITH ENOXAPARIN) TRIAL FROM THE PERSPECTIVE OF HOSPITALS IN GERMANY:RESULTS OF A SUBGROUP ANALYSIS Schädlich PK 1 , Kentsch M 2 ,Weber M 3 , Kämmerer W 4 , Nadipelli V 5 , Huppertz E 6 , Brecht JG 1 1 InForMed GmbH—Outcomes Research & Health Economics, Ingolstadt, Bavaria, Germany; 2 Clinics of Itzehoe, Itzehoe, SH, Germany; 3 Clinics of the City of Cologne, Cologne-Merheim, NRW, Germany; 4 Dr-Horst-Schmidt- Clinics, Wiesbaden, Hesse, Germany; 5 Aventis Pharmaceuticals, Bridgewater, NJ, USA; 6 Aventis Pharma Deutschland, Bad Soden am Taunus, Hesse, Germany OBJECTIVES: To evaluate the cost effectiveness of the low-molecular-weight heparin enoxaparin 40mg once daily (ENOX) relative to no pharmacological prophylaxis (NPP) and to unfractionated heparin 5000 IU thrice daily (UFH) in the prevention of venous thromboembolic