Cost-Utility Analysis of Add-On Vericiguat to Standard Treatment in Thai Patients With Heart Failure and Reduced Ejection Fraction
Author(s)
Tanawan Kongmalai, MD, PhD., Rungroj Krittayaphong, MD, Kanchalaporn Jirataiporn, RN.
Mahidol university, Siriraj hospital, Bangkok, Thailand.
Mahidol university, Siriraj hospital, Bangkok, Thailand.
Presentation Documents
OBJECTIVES: Vericiguat has shown potential in reducing cardiovascular (CV) mortality and heart failure hospitalizations in patients with heart failure reduced injection fraction (HFrEF). However, its cost-effectiveness in Thailand remains uncertain. This study evaluates the cost-effectiveness of adding vericiguat to standard of care (SoC) in Thai patients with HFrEF from the healthcare perspective.
METHODS: A Markov model using Microsoft Excel was conducted to simulate the lifetime economic outcomes of adding vericiguat to SoC compared to SoC 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 performed.
RESULTS: Adding vericiguat to SoC 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 ($3,114) per patient compared to SoC alone, resulting in an incremental cost-effectiveness ratio (ICER) of 1,063,375 THB ($28,857) per QALY gained. Subgroup analysis based on NT-proBNP levels demonstrated that vericiguat had a more favorable ICER of 557,427 THB ($15,127) per QALY gained in patients with NT-proBNP ≤ 4,000 pg/mL. Considering the current willingness-to-pay (WTP) threshold of 160,000 THB ($4,342) per QALY gained in Thailand, vericiguat did not meet the cost-effectiveness criteria. Conclusions: Despite its clinical benefits in reducing HF hospitalizations and CV mortality, vericiguat as an adjunct to SoC for HFrEF patients in Thailand exceeds the accepted cost-effectiveness threshold of 4,342 USD/QALY gained. A price reduction of 90.2% would be necessary to achieve the current Thai WTP threshold.
CONCLUSIONS: Despite its clinical benefits in reducing HF hospitalizations and CV mortality, vericiguat as an adjunct to SoC for HFrEF patients in Thailand exceeds the accepted cost-effectiveness threshold of 4,342 USD/QALY gained. A price reduction of 90.2% would be necessary to achieve the current Thai WTP threshold.
METHODS: A Markov model using Microsoft Excel was conducted to simulate the lifetime economic outcomes of adding vericiguat to SoC compared to SoC 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 performed.
RESULTS: Adding vericiguat to SoC 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 ($3,114) per patient compared to SoC alone, resulting in an incremental cost-effectiveness ratio (ICER) of 1,063,375 THB ($28,857) per QALY gained. Subgroup analysis based on NT-proBNP levels demonstrated that vericiguat had a more favorable ICER of 557,427 THB ($15,127) per QALY gained in patients with NT-proBNP ≤ 4,000 pg/mL. Considering the current willingness-to-pay (WTP) threshold of 160,000 THB ($4,342) per QALY gained in Thailand, vericiguat did not meet the cost-effectiveness criteria. Conclusions: Despite its clinical benefits in reducing HF hospitalizations and CV mortality, vericiguat as an adjunct to SoC for HFrEF patients in Thailand exceeds the accepted cost-effectiveness threshold of 4,342 USD/QALY gained. A price reduction of 90.2% would be necessary to achieve the current Thai WTP threshold.
CONCLUSIONS: Despite its clinical benefits in reducing HF hospitalizations and CV mortality, vericiguat as an adjunct to SoC for HFrEF patients in Thailand exceeds the accepted cost-effectiveness threshold of 4,342 USD/QALY gained. A price reduction of 90.2% would be necessary to achieve the current Thai WTP threshold.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE298
Topic
Economic Evaluation
Topic Subcategory
Thresholds & Opportunity Cost
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)