Comparison of therapies with torasemide or furosemide in patients with congestive heart failure from a pharmacoeconomic viewpoint.

This observational study compared patients suffering from congestive heart failure (CHF) who were treated with loop diuretics torasemide or furosemide. Data documenting the course of the disease and its associated costs over a period of one year were collected retrospectively. A total of 400 CHF patients, 200 in each treatment group, were included in the analysis. Concomitant ACE inhibitor therapy was received by 46% of patients in both groups. More torasemide-treated patients (38.0%) than furosemide-treated patients (24.5%) achieved an improvement in NYHA class in the one-year period. The main difference between the two groups was the number of CHF-related hospitalisations: 62 vs 324 hospital days due to CHF were necessary among torasemide- and furosemide-treated patients, respectively. Thus torasemide treatment was associated with an 80% reduction in hospital days compared with furosemide. Furthermore, about 30% fewer working days were lost in the torasemide group than in the furosemide group (441 days vs 617 days, respectively). Direct and indirect costs were evaluated, resulting in overall annual costs of DEM 1502 per torasemide-treated patient and DEM 1863 per furosemide-treated patient. A cost-effectiveness analysis showed a difference between the therapies of DEM 3651 in favour of torasemide. In conclusion, treatment with torasemide improved clinical outcome and was more cost-effective than with furosemide.