COST-EFFECTIVENESS ANALYSIS OF SACUBITRIL/VALSARTAN COMPARED WITH STANDARD ACEI THERAPIES FOR HEART FAILURE PATIENTS WITH REDUCED EJECTION FRACTION IN TAIWAN
Author(s)
Fann C1, Chen S2
1Kainan University, Taoyuan, Taiwan, 2Novartis (Taiwan), Taipei, Taiwan
Presentation Documents
OBJECTIVES: Heart failure (HF) is highly prevalent in the elderly people and has been considered as an intractable disease due to poor survival and life quality. Recently, a novel oral therapy, sacubitril/valsartan, has proven its efficacy in reducing cardiovascular (CV) mortality (by 20%) and all-cause mortality (by 16%) compared with enalapril, an angiotensin-converting enzyme inhibitor (ACEi) in HF patients with reduced ejection fraction (HFrEF). Taiwan has a universal health insurance program govern by a single payer, National Health Insurance Administration (NHIA). Due to stringent cost containment, the economic evaluation for a new drug is crucial for decision-making. The aim of this study is to perform a cost-effectiveness analysis for sacubitril /valsartan compared with 4 types of ACEi for HFrEF patients from a single payer’s perspective. METHODS: We adopted a 2-state Markov model developed by McMurray et al. The effectiveness was derived from the PARADIGM-HF trial. Medical utilization and cost data were derived from the NHIA claimed data. Both incremental cost-effectiveness ratio (ICER) and incremental cost-utility ratio (ICUR) were estimated. The ceiling ratio was set at Gross Domestic Product (GDP) per capita in Taiwan, around $23,000, per life year gained (LYG). A 3.5% discount rate was used for cost and effectiveness with a lifetime follow-up. RESULTS: The LYG of 0.6838 results in an ICER of $18,449 for sacubitril /valsartan vs. enalapril. The corresponding ICERs are $17,750, $17,638, $17,774 for ramipril, prindopril, and lisinopril, respectively. The quality-adjusted life year (QALY) gained of 0.5646 results in an ICUR of $22,345 for sacubitril /valsartan vs. enalapril. The most influential parameter in univariate sensitivity analysis is the constant term in the statistical model of CV mortality. CONCLUSIONS: Sacubitril/valsartan compared with ACEi for HFrEF patients is cost-effective given on a ceiling ratio of $23,000 per LYG in Taiwan.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCV93
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders