HFrEF progression and associated lifetime outcomes. To estimate treatment effects and utilities, the model was calibrated with data from the PARADIGM-HF trial. Baseline population characteristics were adapted to match a real-world population of patients already being treated with sacubitril/valsartan (patients from an observational study conducted in Portugal, the PRiMe study). Results are expressed as hospitalizations and deaths estimated to be avoided, as well as life-years (LY) and quality adjusted life-years (QALY) estimated to be gained with sacubitril/valsartan versus enalapril. A 5-year time horizon and a 5% discount rate were considered. Results: Assuming that the total number of patients treated with sacubitril/valsartan are persistent and that they have the same baseline characteristics as the patients recruited in the PRiMe study, after 5-years of treatment, we estimate to have avoided 2,553 hospitalizations (647 hospitalizations due to HF, 946 due to other cardiovascular events and 960 non-cardiovascular). Similarly, a total of 494 deaths are estimated to be avoided after 5-years versus a scenario with enalapril. A benefit of 1,161 LY and 1,173 QALY gained over a period of 5-years is also estimated. Conclusions: Sacubitril/valsartan is estimated to have a high impact on morbidity and mortality in the Portuguese population which is shown by the number of hospitalizations and deaths estimated to be avoided and LY and QALY estimated to be gained in the currently treated population.
in Spain, an updated economic assessment is required. We analyzed the costeffectiveness of rosuvastatin compared to atorvastatin in the treatment of patients at moderate, high and very high cardiovascular risk (1% Systematic Coronary Risk Evaluation [SCORE]) from the Spanish National Healthcare System (NHS) perspective. METHODS: A Markov model was developed in Microsoft Excel. Four health states were defined: patients without cardiovascular event, cerebrovascular event, coronary event and death. The highest doses of each statin intensity group were compared: rosuvastatin 10mg versus atorvastatin 20mg (moderate-intensity), and rosuvastatin 20mg versus atorvastatin 80mg (high-intensity). A time horizon of 25 years and an annual cycle length were considered. Pharmacological, monitoring, and resource use costs related to cardiovascular events were included in the model. Rosuvastatin and atorvastatin efficacy in terms of c-LDL reduction were taken from the ESC/EAS 2016 European guidelines. Utility values were associated with each health state. A 3% annual discount rate was used for costs and benefits. Incremental cost-effectiveness ratios (ICER) were estimated for each comparison and SCORE risk profile (based on gender, age, total cholesterol, blood pressure and smoking habit). A willingnessto-pay threshold of V30,000/QALY was assumed. RESULTS: Overall, 426 SCORE risk profiles were evaluated: 288 moderate, 86 high and 52 very high risk. The ICERs showed that rosuvastatin 10mg was cost-effective versus atorvastatin 20mg in 35% of the moderate profiles, the ICERs remaining were above V30,000/ QALY; 98% of the high-risk profiles and 100% of the very high-risk profiles.
23-42%). This resulted in a difference in cumulative budget impact of 64% over 5 years, driven by the equilibrium in patient numbers initiating and discontinuing treatment in the complex model. Conclusions: As with any quantitative analysis, when conducting a BIA all methodological assumptions should be considered. A simple approach, not utilising the survival function directly, may not estimate the budget impact accurately, and a complex approach provides important additional accuracy by ensuring a more accurate timing of transition at the point of discontinuation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.