Lower Hospitalization and Healthcare Costs With Sacubitril/Valsartan Versus Angiotensin‐Converting Enzyme Inhibitor or Angiotensin‐Receptor Blocker in a Retrospective Analysis of Patients With Heart Failure

Figures

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  Figure 1. Criteria for claims evidence of HFrEF and stable status. Rule‐out claims (diagnostic services claims) included medical claims with a diagnosis code and diagnostic service procedure code(s) without any other services. Non–rule‐out claims represented medical claims other than rule‐out claims. AIDS indicates acquired immunodeficiency syndrome; CPT, current procedural terminology; HCPCS, Healthcare Common Procedure Coding System; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; ICD‐9‐CM, International Classification of Diseases, Ninth Edition, Clinical Modification; ICD‐10‐CM, International Classification of Diseases, Tenth Edition, Clinical Modification.

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  Figure 2. Patient selection and attrition. Identification period: October 1, 2015 through June 30, 2016. Index date: date of first pharmacy claim for SAC/VAL or ACEI/ARB. ACEI/ARB indicates angiotensin‐converting enzyme inhibitor or angiotensin‐receptor blocker; CRT/ICD, cardiac resynchronization therapy/implantable cardioverter‐defibrillator; HFrEF, heart failure with reduced ejection fraction; MI, myocardial infarction; PDC, proportion of days covered; SAC/VAL, sacubitril/valsartan. *Criteria for claims evidence of HF and stable status are provided in Figure 1. †Variables used in propensity score matching are provided in Table 1.

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  Figure 3. Kaplan–Meier plots of first postindex hospitalization. Patient data are observed until each event of interest (HF hospitalization or all‐cause hospitalization) or patient postindex is censored (earliest of end of study period, health plan disenrollment, or death). Log‐rank tests: P=0.031 for HF hospitalization; P<0.001 for all‐cause hospitalization (SAC/VAL cohort vs ACEI/ARB cohort). ACEI/ARB indicates angiotensin‐converting enzyme inhibitor or angiotensin‐receptor blocker; HF, heart failure; SAC/VAL, sacubitril/valsartan.

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  Figure 4. Per‐patient per‐month (PPPM) postindex healthcare costs. Combined health plan–paid+patient‐paid amounts (top) and patient‐paid amounts (bottom) are shown. *P<0.05; **P<0.001. ACEI/ARB indicates angiotensin‐converting enzyme inhibitor or angiotensin‐receptor blocker; HF, heart failure; SAC/VAL, sacubitril/valsartan.