Key result
Ivabradine combined with standard care was more cost-effective than standard care alone in most studies, with ICERs ranging from $10,616/QALY in Thailand to $55,600/QALY in the USA.
Why the study?
Chronic heart failure carries high morbidity and mortality, prompting a need to systematically evaluate the cost-effectiveness of ivabradine added to standard treatment.
Is ivabradine plus standard treatment cost-effective compared to standard treatment alone in patients with heart failure?
Systematic Review (n=6)
Yes
Is ivabradine plus standard treatment cost-effective compared to standard treatment alone in patients with heart failure?
Ivabradine added to standard care for heart failure appears cost-effective across multiple countries, though results are sensitive to country-specific willingness-to-pay thresholds.
Supports ivabradine addition to HF care where local WTP thresholds are met; extends efficacy data with multinational economic evaluations.
BACKGROUND: Chronic heart failure (CHF) is a clinical status and a progressive health disorder extremely related to increased morbidity and mortality worldwide. Accordingly, this study aimed to assess systematic review of literature on cost-effectiveness done in patients with heart failure receiving Ivabradine plus standard treatment compared with standard treatment alone. AREAS COVERED: This study is a systematic review in which all published articles related to the study topic were assessed in time range of 2014-2020. In order to find articles, internet search in foreign databases of PubMed, Embase, ISI/Web of Science (WoS), SCOPUS, Global Health databases, through keywords related to the objective was performed. Six articles out of 1524 article related to final topic were assessed. In addition, quality of studies was evaluated using CHEERS checklist. In six countries investigated (Iran, Thailand, Australia, United States of America, United Kingdom, and Greece), willingness-to-pay (WTP) thresholds higher cost per QALY, and highest ICER for Ivabradine was in USA (55,600 $/QALY) and the lowest was in Thailand (10,616$/QALY). Most items of CHEERS were estimated in the studies and studies had good quality. EXPERT OPINION: Regarding our investigation, ivabradine combined with standard care was more cost-effective than standard care alone in most of the evaluated studies, although the cost of this intervention was higher than its effectiveness. However, the threshold chosen by each country can have a significant impact on these results. And to have a more accurate result, it is required to pay more attention to the income level in different countries.
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Kemmak et al. (2021) conducted a systematic review in Chronic heart failure (CHF) (n=6). Ivabradine plus standard treatment vs. Standard treatment alone was evaluated on Cost-effectiveness (ICER). Ivabradine combined with standard care was more cost-effective than standard care alone in most studies, with ICERs ranging from $10,616/QALY in Thailand to $55,600/QALY in the USA.
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