Key result
Vericiguat added to standard therapy for HFrEF is not cost-effective in Thailand at ~$28,857/QALY.
Why the study?
The cost-utility of adding vericiguat to standard-of-care therapy for HFrEF patients with worsening HF events in Thailand's healthcare system was unknown.
Is adding vericiguat to standard-of-care therapy cost-effective in Thai patients with HFrEF and worsening HF events?
Is adding vericiguat to standard-of-care therapy cost-effective in Thai patients with HFrEF and worsening HF events?
Vericiguat added to standard-of-care therapy for HFrEF is not cost-effective in Thailand at current pricing, requiring a 90.2% price reduction to meet the willingness-to-pay threshold.
OBJECTIVES: This study aimed to evaluate the cost-utility of adding vericiguat to standard-of-care therapy for patients with heart failure with reduced ejection fraction (HFrEF) and worsening heart failure (HF) events in the context of Thailand's healthcare system. METHODS: A Markov model using Microsoft Excel was conducted to simulate the lifetime economic outcomes of adding vericiguat to standard-of-care therapy (SoCT) compared with SoCT alone for Thai patients with HFrEF. Model parameters were derived from the VICTORIA trial and supplemented with local data on healthcare costs and utilities. Sensitivity, subgroup, and threshold analyses were also performed. RESULTS: Adding vericiguat to SoCT increased total life-years (LYs) from 5.80 to 5.98 and quality-adjusted life-years (QALYs) from 2.74 to 2.85. However, it also increased total lifetime costs by 114 740 THB ($3114) per patient compared with SoCT alone, resulting in an incremental cost-effectiveness ratio of 1 063 375 THB ($28 857) per QALY gained. Subgroup analysis based on NT-proBNP levels demonstrated that vericiguat had a more favorable incremental cost-effectiveness ratio of 557 427 THB ($15 127) per QALY gained in patients with NT-proBNP ≤ 4000 pg/mL. Considering the current willingness-to-pay threshold of 160 000 THB ($4342) per QALY gained in Thailand, vericiguat did not meet the cost-effectiveness criteria. CONCLUSIONS: Despite its clinical benefits in reducing HF hospitalizations and cardiovascular mortality, vericiguat as an adjunct to SoCT for patients with HFrEF in Thailand exceeds the accepted cost-effectiveness threshold of 4342 USD/QALY gained. A price reduction of 90.2% would be necessary to achieve the current Thai willingness-to-pay threshold.
No takes yet. Share an insight, caveat, or question.
Kongmalai et al. (2025) studied Heart failure with reduced ejection fraction (HFrEF) and worsening heart failure events. Vericiguat vs. Standard-of-care therapy (SoCT) alone was evaluated on Incremental cost-effectiveness ratio (ICER) per QALY gained (ICER 1 063 375 THB ($28 857) per QALY gained). Adding vericiguat to standard-of-care therapy for HFrEF in Thailand yielded an ICER of $28,857 per QALY gained, exceeding the accepted willingness-to-pay threshold of $4,342/QALY.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: