Reduced heart failure-related healthcare costs with Furoscix versus in-hospital intravenous diuresis in heart failure patients: the FREEDOM-HF study

Plain language summary: reduced heart failure costs with subcutaneous Furoscix at home versus in-hospital intravenous diureticsWhat is this article about? In heart failure (HF), the heart cannot pump as well as it should. This causes blood to back up in the vessels that return blood to the heart. Fluid leaks from these vessels and collects in vital organs such as the lungs. This fluid build-up is called congestion. Congestion causes symptoms such as shortness of breath, tiredness and leg swelling. Furoscix is a prescription medicine, a diuretic, that treats congestion. Diuretics help get rid of extra fluid by increasing urination. Congestion is usually managed with oral diuretics, but sometimes congestion cannot be controlled by oral diuretics and patients may have to spend several days at a clinic or hospital to receive diuretics given through a vein (intravenous or IV). Furoscix is a new formulation of furosemide, a common diuretic, and is delivered into the skin (subcutaneous) by a self-administered pump instead of through an IV. Our investigation aimed to answer two questions Can Furoscix be given to patients at home instead of in the hospital with IV diuretics? Is there a cost savings to using Furoscix? Instead of being admitted to the hospital for IV diuretics, HF patients with worsening congestion who came to the emergency department were sent home to receive Furoscix 80 mg/10 ml 5-h subcutaneous infusion for & LE;7 days. 30-day costs related to HF in these patients were compared with costs from similar group of patients previously hospitalized for IV diuretics. What were the results & what do they mean? In patients who needed to be admitted to the hospital for IV diuretics, Furoscix given at home instead reduced congestion and resulted in significant cost savings. Patients with heart failure, who are not getting relief with oral diuretics, can be treated with Furoscix at home without having to be admitted to the hospital for IV diuretics. Use of Furoscix instead of IV furosemide can save money to the healthcare system. Aim: Compare heart failure (HF) costs of Furoscix use at home compared with inpatient intravenous (IV) diuresis. Patients & methods: Prospective, case control study of chronic HF patients presenting to emergency department (ED) with worsening congestion discharged to receive Furoscix 80 mg/10 ml 5-h subcutaneous infusion for & LE;7 days. 30-day HF-related costs in Furoscix group derived from commercial claims database compared with matched historical patients hospitalized for Results: Of 24 Furoscix patients, 1 (4.2%) was hospitalized in 30-day period. Sixty-six control patients identified and were well-matched for age, sex, ejection fraction (EF), renal function and other comorbidities. Furoscix patients had reduced mean per patient HF-related healthcare cost of $16,995 (p < 0.001). Conclusion: Furoscix use was associated with significant reductions in 30-day HF-related healthcare costs versus matched hospitalized controls. Tweetable abstractCompared with a historical matched cohort of patients admitted to hospital for & LE;72 h to receive intravenous (IV) furosemide, use of Furoscix at home resulted in a per patient reduction in heart failure-related costs of $16,995.