Cost-Effectiveness of Sacubitril–Valsartan in Patients With Heart Failure With Reduced Ejection Fraction

• DOI: 10.7326/m16-0057
• Publication Date: 2016-08-29T22:30:35Z
• Authors: Alexander T. Sandhu; Daniel A. Ollendorf; Richard H. Chapman; Steven D. Pearson; Paul A. Heidenreich
• Keywords: Sacubitril; Sacubitril, Valsartan

Sacubitril-valsartan therapy reduces cardiovascular mortality compared with enalapril in patients heart failure reduced ejection fraction.To evaluate the cost-effectiveness of sacubitril-valsartan versus angiotensin-converting enzyme inhibitor chronic failure.Markov decision model.Clinical trials, observational analyses, reimbursement data from Centers for Medicare & Medicaid Services, drug pricing databases, and Disease Control Prevention life tables.Patients at an average age 64 years, New York Heart Association (NYHA) class II to IV failure, left ventricular fraction 0.40 or less.Lifetime.Societal.Treatment lisinopril.Life-years, quality-adjusted life-years (QALYs), costs, hospitalizations, incremental ratios.The group experienced 0.08 fewer hospitalization, 0.69 additional life-year, 0.62 QALY, $29 203 equating a cost per QALY gained $47 053. The was $44 531 NYHA $58 194 those III failure.Sacubitril-valsartan treatment most sensitive duration improved outcomes, $120 623 if limited length trial (median, 27 months). No variations other parameters caused exceed $100 000 gained.The benefit is based on single clinical trial.Treatment provides reasonable value reducing morbidity failure.U.S. Department Veterans Affairs Institute Clinical Economic Review.