Cost of $47,053 per quality-adjusted life-year gained in base-case analysis
TUESDAY, Aug. 30, 2016 (HealthDay News) — For patients with heart failure with reduced ejection fraction, sacubitril-valsartan is cost-effective for reducing cardiovascular mortality and morbidity, according to a study published online Aug. 30 in the Annals of Internal Medicine.
Alexander T. Sandhu, M.D., from the Veterans Affairs Palo Alto Health Care System in California, and colleagues designed a Markov decision model to examine the cost-effectiveness of sacubitril-valsartan versus angiotensin-converting enzyme inhibitor therapy in patients with chronic heart failure. The target population was made up of patients (average age, 64 years) with New York Heart Association (NYHA) class II to IV heart failure, and a left ventricular ejection fraction of 0.40 or less.
The researchers found that the sacubitril-valsartan group experienced 0.08 fewer heart failure hospitalizations, 0.69 additional life-years, 0.62 additional quality-adjusted life-years (QALYs), and $29,203 in incremental costs, for a cost of $47,053 per QALY gained in the base-case analysis. In patients with NYHA class II heart failure and NYHA class III or IV heart failure, the cost per QALY gained was $44,531 and $58,194, respectively. In sensitivity analysis, treatment was most sensitive to the duration of improved outcomes, with a cost of $120,623 per QALY gained if the duration was limited to the length of the trial (median, 27 months).
“Treatment with sacubitril-valsartan provides reasonable value in reducing cardiovascular mortality and morbidity in patients with NYHA class II to IV heart failure,” the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Novartis, which manufactures sacubitril-valsartan.
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