Cost-Utility Analysis of Sacubitril/Valsartan Use Compared With Standard Care in Chronic Heart Failure Patients With Reduced Ejection Fraction in South Korea

Park, Sun‐Kyeong; Hong, Seung Ho; Kim, HyoJin; Kim, Seong-Ju; Lee, Eui-Kyung

doi:10.1016/j.clinthera.2019.04.031

Cited by 28 publications

(28 citation statements)

References 45 publications

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“…Due to the relatively lower WTP (between SGD 20,000 to SGD 50,000) in Singapore, the price of Sac-Val has to be reduced by 32% to 70% for it to be cost-effective. Recently, a cost-effect evaluation of Sac-Val in South Korea (Park et al, 2019) concluded that Sac-Val is cost-effective compared to ACEIs, although the ICER was higher than that in our study.…”

Section: Discussioncontrasting

confidence: 84%

“…Apart from the therapeutic effects, the results from PARADIGM-HF have also been used for evaluating the economic viability of Sac-Val ( Liu et al, 2020 ), especially in the developed countries ( Gaziano et al, 2016 ; King et al, 2016 ; Sandhu et al, 2016 ; van der Pol et al, 2017 ; Zanfina et al, 2017 ; Gandjour and Ostwald, 2018 ; Krittayaphong and Permsuwan, 2018 ; Liang et al, 2018 ; Zueger et al, 2018 ; Park et al, 2019 ; van der Pol et al, 2019 ). Owing to the high willingness-to-pay (WTP) threshold, Sac-Val is likely to be cost-effective compared to enalapril in United States ( Gaziano et al, 2016 ; King et al, 2016 ; Sandhu et al, 2016 ), United Kingdom ( McMurray et al, 2018 ) and some other European countries ( Zanfina et al, 2017 ; Gandjour and Ostwald, 2018 ; McMurray et al, 2018 ; van der Pol et al, 2019 ) despite the higher acquisition cost.…”

Section: Introductionmentioning

confidence: 99%

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Sacubitril-Valsartan Compared With Enalapril for the Treatment of Heart Failure: A Decision-Analytic Markov Model Simulation in China

Tian

Peipei

et al. 2020

Front. Pharmacol.

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Objectives: Heart failure with reduced ejection fraction (HFrEF) is a major health concern globally due to high mortality rates, frequent hospitalization and considerable medical expenditure. The prevalence of HFrEF is steadily rising in Asian countries, and populous, developing countries like China are facing a significant socioeconomic burden as a result. Sacubitril-valsartan (Sac-Val) is currently a class I recommendation for treating HFrEF in major guidelines, although it has not been pharmaco-economically evaluated in China. To this end, we compared the cost-effectiveness of Sac-Val and enalapril based on the negotiated prices in order to fully assess the expected costs and benefits of the clinical use of Sac-Val in China. Method: A Markov model was constructed to estimate long-term clinical and economic outcomes of Sac-Val versus enalapril for HFrEF patients in China over a 10-year horizon. Primary model outcomes were total costs and quality-adjusted life years (QALYs), and the incremental cost-effectiveness ratio (ICER). Results: Treatment with Sac-Val resulted in 4.67 QALYs at the cost of $4,684.25, while enalapril yielded 4.40 QALYs at the cost of $4,014.47. Compared to enalapril, Sac-Val was associated with a gain of 0.27 QALYs, resulting in an ICER of $ 2,480.67 per QALY. Deterministic sensitivity analysis showed robust results. Probabilistic sensitivity analysis suggested that Sac-Val has a 99.99% probability of being cost-effective at the willingnessto-pay threshold of $10,276. Conclusion: From Chinese patients' perspective, Sac-Val is a cost-effective treatment option for HFrEF in China compared to enalapril. Our findings can aid clinicians plan the Sac-Val regimen, as well as decision makers to discuss the value and position of novel angiotensin receptor neprilysin inhibitors (ARNIs) in future.

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Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Sacubitril-Valsartan Compared With Enalapril for the Treatment of Heart Failure: A Decision-Analytic Markov Model Simulation in China

Tian

Peipei

et al. 2020

Front. Pharmacol.

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“…Therefore, the main analysis might not differ significantly from the present results if we also consider the AEs. 10,44 Furthermore, due to limited data on HRQoL, the utility values were also from previous studies, while in reality, these estimations may differ between countries. These uncertainties were addressed by conducting both deterministic and probabilistic sensitivity analyses, where the https://doi.org/10.2147/CEOR.S322740…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness Analysis of Sacubitril/Valsartan Compared to Enalapril for Heart Failure Patients in Indonesia

Zakiyah¹,

Sinuraya²,

Kusuma³

et al. 2021

CEOR

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Objective: Sacubitril/valsartan is a relatively new medication that is more effective than the usual enalapril for heart failure patients with reduced ejection fraction. Therefore, this study aims to determine the cost-effectiveness of sacubitril/valsartan compared to enalapril in Indonesia's healthcare system. Methods: In this study, a Markov decision-analytic model was developed to estimate the total cost, health outcomes, and cost-effectiveness of sacubitril/valsartan compared to enalapril from Indonesia's healthcare perspective. The input parameters for the cost-effectiveness were predominantly from the PARADIGM-HF trial. Subsequently, the country-specific data were synthesized for medication and hospitalization costs, cardiovascular and non-cardiovascular death, as well as re-hospitalization rate. The incremental cost-effectiveness ratio (ICER) per quality-adjusted life years (QALYs) gained was estimated to determine the cost-effectiveness. Deterministic and probabilistic sensitivity analyses were conducted to assess the impact of parameter uncertainty. Results and Discussion: In the base case, sacubitril/valsartan was more costly and effective

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“…We modeled the different costs and utilities from the included countries to compare the pharmacoeconomic benefits from the healthcare system's perspective. The values of the input parameters were extracted from the published sources (Supplementary Table 2) (25)(26)(27)(28)(29). Base-case analysis and PSA were both performed for each country.…”

Section: Probabilistic Sensitivity Analysesmentioning

confidence: 99%

Cost-Effectiveness Evaluation of Add-on Empagliflozin in Patients With Heart Failure and a Reduced Ejection Fraction From the Healthcare System's Perspective in the Asia-Pacific Region

Liao

Yang

Kuo

et al. 2021

Front. Cardiovasc. Med.

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Background: EMPEROR-Reduced trial provides promising evidence on the efficacy of empagliflozin adding to the standard treatment in patients with heart failure and reduced ejection fraction (HFrEF). This study aimed to investigate the cost-effectiveness of add-on empagliflozin vs. standard therapy alone in HFrEF from the perspective of the Asia-Pacific healthcare systems.Methods: A Markov model was constructed to simulate HFrEF patients and to project the lifetime direct medical costs and quality-adjusted life years (QALY) of both therapies. Transitional probabilities were derived from the EMPEROR-Reduced trial. Country-specific costs and utilities were extracted from published resources. Incremental cost-effectiveness ratio (ICER) against willingness to pay (WTP) threshold was used to examine the cost-effectiveness. A series of sensitivity analyses was performed to ensure the robustness of the results.Results: The ICERs of add-on empagliflozin vs. standard therapy alone in HFrEF were US$20,508, US$24,046, US$8,846, US$53,791, US$21,543, and US$20,982 per QALY gained in Taiwan, Japan, South Korea, Singapore, Thailand, and Australia, respectively. Across these countries, the probabilities of being cost-effective for using add-on empagliflozin under the WTP threshold of 3-times country-specific gross domestic product per capita were 93.7% in Taiwan, 95.6% in Japan, 96.3% in South Korea, 94.2% Singapore, 51.9% in Thailand, and 95.9% in Australia. The probabilities were reduced when shortening the time horizon, assuming the same cardiovascular mortality for both treatments, and setting lower WTP thresholds.Conclusion: Adding empagliflozin to HFrEF treatment is expected to be a cost-effective option among the Asia-Pacific countries. The cost-effectiveness is influenced by the WTP thresholds of different countries.

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Cost-Utility Analysis of Sacubitril/Valsartan Use Compared With Standard Care in Chronic Heart Failure Patients With Reduced Ejection Fraction in South Korea

Cited by 28 publications

References 45 publications

Sacubitril-Valsartan Compared With Enalapril for the Treatment of Heart Failure: A Decision-Analytic Markov Model Simulation in China

Sacubitril-Valsartan Compared With Enalapril for the Treatment of Heart Failure: A Decision-Analytic Markov Model Simulation in China

Cost-Effectiveness Analysis of Sacubitril/Valsartan Compared to Enalapril for Heart Failure Patients in Indonesia

Cost-Effectiveness Evaluation of Add-on Empagliflozin in Patients With Heart Failure and a Reduced Ejection Fraction From the Healthcare System's Perspective in the Asia-Pacific Region

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