Cost-Effectiveness Analysis of Adding Ivabradine to Current Standard Therapy Versus Standard Therapy Alone in Patients with Chronic Heart Failure in Japan

Ivabradine is indicated as a new treatment option for heart rate reduction in patients with reduced ejection fraction heart failure. This study aims to assess the cost-effectiveness of ivabradine on top of standard therapy in patients with chronic heart failure in Japan.A two-state Markov model was used to analyze the cost-effectiveness of ivabradine from a Japanese health-care payer perspective. The Quality-Adjusted Life Year (QALY) was set as an outcome measure. Two study population cohorts were included in this analysis: patients with chronic heart failure with a resting heart rate ≥ 75 beats per min (bpm) and those with a resting heart rate ≥ 70 bpm.The incremental cost-effectiveness ratio for ivabradine with standard therapy compared to standard therapy alone was estimated as JPY 2,460,952 per QALY gained for the ≥ 75 bpm population and JPY 2,556,899 per QALY for the ≥ 70 bpm population. With a willingness-to-pay threshold of JPY 5,000,000 per QALY, ivabradine with standard therapy was 90% more likely to be cost-effective for the ≥ 75 bpm cohort in Japan. These findings were found to be robust in both the sensitivity and scenario analyses.This study suggests that adding ivabradine to standard therapy represents a cost-effective treatment option for chronic heart failure patients with reduced ejection fraction in Japan.