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March 16, 2026Value in Health Regional Issues0 citationsOpen Access

Cost-effectiveness of Add-On Ivabradine Versus Standard Pharmacotherapy in the Treatment of Heart Failure in Vietnam: An Analysis From a Health System Perspective

ATAnh ToanTPToi Lam PhungATAn Tran-Duy

Key Result

Adding ivabradine to standard pharmacotherapy is likely to be cost-effective for treating heart failure in Vietnam.

Key Points

  • The central aim is to evaluate the cost-effectiveness of adding ivabradine to standard pharmacotherapy for heart failure in Vietnam.
  • Analyzed treatment strategies from a health system perspective
  • Compared costs and health outcomes of ivabradine and standard pharmacotherapy
  • Evaluated implications for price negotiations and resource allocation
  • Ivabradine addition is likely to be cost-effective for heart failure treatment
  • Supports value-based pricing strategies in the Vietnamese health system
  • Indicates efficient use of healthcare resources for managing costs

Structured PICO

Does adding ivabradine to standard pharmacotherapy improve cost-effectiveness in Vietnamese patients with heart failure (LVEF ≤35%, HR ≥70 bpm)?

P
Population
Simulated cohort of 1,000 Vietnamese patients with heart failure, NYHA class II-IV, LVEF ≤35%, and resting heart rate ≥70 bpm, start age 60, 76% male.
I
Intervention
Ivabradine (doses assumed similar to SHIFT trial: 7.5 mg, 5 mg, 2.5 mg) added to standard pharmacotherapy (RAAS inhibitors, beta-blockers, MRAs, SGLT2 inhibitors) over a lifetime horizon.
C
Comparator
Standard pharmacotherapy alone (RAAS inhibitors, beta-blockers, MRAs, SGLT2 inhibitors based on Vietnamese guidelines and local prescription rates).
O
Outcome
Incremental cost-effectiveness ratio (ICER) measured in cost per quality-adjusted life-year (QALY) gained over a lifetime horizon.

Adding ivabradine to standard pharmacotherapy is a cost-effective strategy for eligible heart failure patients in Vietnam, supporting value-based pricing and resource allocation.

Limitations

  • Health system perspective instead of societal or patient perspective, missing indirect and nonmedical costs.
  • Model assumed 100% medication adherence and did not explicitly incorporate adverse events.
  • Unable to conduct external validation by comparing model outcomes with real-world data due to limited local epidemiological data.
  • Transition probabilities derived from published literature and the SHIFT trial might not accurately reflect the Vietnamese patient population.

Abstract

From a Vietnamese health system perspective, adding ivabradine to standard pharmacotherapy is likely to be a cost-effective strategy for treating eligible patients with HF. This evidence supports value-based pricing in price negotiations and efficient resource use.

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Cite This Study

Toan et al. (2026) studied this question. Adding ivabradine to standard pharmacotherapy is likely to be cost-effective for treating heart failure in Vietnam.

synapsesocial.com/papers/69b79df38166e15b153ab2c9https://doi.org/10.1016/j.vhri.2026.101594
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