Key result
Sacubitril/valsartan proves more cost-effective than vericiguat for Chinese HFrEF patients, yielding more QALYs at lower cost.
Why the study?
The cost-utility of adding sacubitril/valsartan or vericiguat to standard heart failure treatment in Chinese patients with HFrEF was unclear.
Is adding sacubitril/valsartan more cost-effective than adding vericiguat to standard treatment in Chinese patients with HFrEF?
Is adding sacubitril/valsartan more cost-effective than adding vericiguat to standard treatment in Chinese patients with HFrEF?
Adding sacubitril/valsartan to standard therapy is more cost-effective than adding vericiguat for Chinese patients with HFrEF.
May inform sacubitril/valsartan preference in Chinese HFrEF models; leaves open head-to-head trials and real-world validation.
BACKGROUND: PARADIGM-HF and VICTORIA studies have shown that treatment with sacubitril/valsartan or vericiguat could reduce cardiovascular mortality and hospitalisation in the patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, the cost-utility analysis of adding sacubitril/valsartan or vericiguat to the standard treatment of heart failure in Chinese patients with HFrEF was still unclear. METHODS: Based on the Chinese healthcare system, a multi-state Markov model has been established for the cost-utility analysis and compared with the results of VICTORIA study subgroups and relevant local data in China. This model simulated the direct medical costs and quality-adjusted life years (QALYs) of HFrEF patients over a period of 20 years, in which these patients were treated with the standard treatment of heart failure and either adding sacubitril/valsartan or vericiguat. Moreover, incremental cost-utility ratio (ICUR) and incremental net monetary benefit (INMB) were also analysed and the robustness of the results was verified by using sensitivity analysis. RESULTS: In the base case study, according to the Chinese HFrEF patients, the total costs for the sacubitril/valsartan group and the vericiguat group were 4,237.42 USD and 4,618.59 USD, respectively, and the total utility was 3.62 and 3.48 QALYs, respectively. The ICUR was -2,611.68 USD/QALY, and the INMB was -5,772.32 USD. The sensitivity analysis indicated that the results were robust. The results of scenario analysis and base-case analysis were basically consistent. CONCLUSIONS: On the standard treatment of heart failure, adding sacubitril/valsartan alone was more cost-effective than adding vericiguat alone for the treatment of HFrEF.
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Zhao et al. (2025) studied Heart failure with reduced ejection fraction (HFrEF). Sacubitril/valsartan vs. Vericiguat was evaluated on Total utility (QALYs) and costs (ICUR -2,611.68 USD/QALY). Adding sacubitril/valsartan to standard therapy was more cost-effective than adding vericiguat for Chinese HFrEF patients, yielding 3.62 vs 3.48 QALYs and costing 4,237.42 vs 4,618.59 USD.
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