InForMed Gesellschaft fur interdisziplinare Forschung und Beratung im Gesundheitswesen mbH， Hamburg， Germany. Schaedlich@informed.de

OBJECTIVE: Data from the Acute Infarction Ramipril Efficacy (AIRE) study were used in a cost-effectiveness analysis to determine the incremental cost per life-year gained (LYG) when the ACE inhibitor ramipril was added to conventional treatment in patients with heart failure after acute myocardial infarction. In the AIRE trial， the addition of ramipril significantly lowered rates of total mortality and rehospitalisation due to heart failure.

DESIGN AND SETTING: The cost-effectiveness analysis was conducted from the perspective of the Statutory Health Insurance (SHI) provider in Germany. A modelling approach was used which was based on secondary analysis of existing data， and costs were those incurred by SHI (i.e. expenses of SHI). In the base-case analysis， average case-related expenses of SHI were applied and LYG were quantified by the method of Kaplan and Meier.

MAIN OUTCOME MEASURES AND RESULTS: The incremental cost-effectiveness ratios of ramipril varied between 2500 and 8300 deutschmarks (DM) per LYG (1993 values for inpatient and 1995 values for outpatient treatment; DM1 approximately