Why the study?
To summarize cost-effectiveness evidence for sacubitril/valsartan in heart failure with reduced ejection fraction and describe the impact of different modeling approaches and parameters on the results.
Is sacubitril/valsartan cost-effective in patients with HFrEF?
Is sacubitril/valsartan cost-effective in patients with HFrEF?
A systematic review of cost-effectiveness models demonstrates that sacubitril/valsartan is generally considered a cost-effective therapy for patients with HFrEF.
Answers are grounded in this paper and cite their sources.
Sacubitril/valsartan is cost-effective in most HFrEF models; leaves open standardization of parameters for consistent payer decisions.
OBJECTIVES: To summarize cost-effectiveness (CE) evidence of sacubitril/valsartan for the treatment of heart failure (HF) patients with reduced ejection fraction (HFrEF). The impact of different modeling approaches and parameters on the CE results is also described. We also reviewed HTA countries' websites to identify CE reports of sacubitril/valsartan, published up to 25-July-2021. Articles published in English as full-texts, conference-abstracts, or HTA reports were included. RESULTS: We included 44 CE models [39 from 37 publications (22 full-texts; 15 conference-abstracts) and 5 HTAs; Europe, n = 20; North and South Americas, n = 14; Asia and Australia, n = 10]. Most models adopted a Markov structure with constant transition probabilities of events (n = 27) or a mix of Markov and regression-based models (n = 16), with variations in structural assumptions and chosen parameters. Study authors concluded sacubitril/valsartan to be a cost-effective therapy in 37/41 models in chronic HFrEF patients and 2/3 models in hospitalized patients stabilized after an acute decompensation for HF. CE models showing sacubitril/valsartan not to be a cost-effective treatment generally modeled a shorter time horizon. Effect of sacubitril/valsartan on cardiovascular and all-cause mortality, cost, duration of effect and time horizon was the main model drivers. CONCLUSIONS: Most evidence indicated sacubitril/valsartan is cost-effective in HFrEF. The use of a lifetime horizon is recommended in future models as HF is a chronic disease. Data on the CE of sacubitril/valsartan in the inpatient setting were limited and further research is warranted.
No takes yet. Share an insight, caveat, or question.
Proudfoot et al. (2022) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: