THE COST EFFECTIVENESS OF SACUBITRIL/VALSARTAN FOR THE TREATMENT OF CHRONIC HEART FAILURE WITH REDUCED EJECTION FRACTION IN KOREA
Author(s)
Lee J, Ko S
Novartis Korea, Seoul, Korea, Republic of (South)
OBJECTIVES: This study aims to estimate the cost-effectiveness of sacubitril/Valsartan compared with Enalapril for the treatment of chronic heart failure patients with reduced ejection fraction (HFrEF) in Korea. METHODS: A regression-based cohort-model was used comparing sacubitril/Valsartan with ACEi (Enalapril) in chronic heart failure patients with HFrEF New York Heart Association Functional Classification II-IV symptoms. Health statues in Markov model to evaluate all-cause mortality, hospitalizations, adverse events and quality-of-life for each treatment groups over life time horizon (30 years). The primary source of clinical evidence was the PARADIGM-HF study. Costs and Health outcomes were evaluated over lifetime (30 years), discounted at 5% from the perspective of the health-care perspective. Alternative analyses were implemented that cardiovascular mortality based on PARADIGM-HF trial and non-cardiovascular mortality obtained from Korea life-tables. Cost data was mainly from National insurance statistical data in Korea, and Utility values were derived from survey results with general population to capture the Korean-specific health status values. The outcome of interest was incremental cost-effectiveness ratio (ICER), expressed as cost per quality adjusted life year (QALY) gained. RESULTS: The expected costs and QALYs of treating HFrEF with sacubitril/Valsartan are higher than ACEi (Enalapril) with 5% discounted rate for 30 years. The sacubitril/Valsartan strategy compared to Enalapril showed a decrease in the number of hospitalizations (8% reduction annually) and hospitalization costs (around 396 USD for lifetime). The base case scenario shows that ICER of sacubitril/Valsartan versus ACEi (Enalapril) would be around 15,160 USD per QALYs gained. With 3% discount rate, ICER value would be 14,189 USD per QALYs gained. The results were robust in one-way sensitivity analyses. Exchange rate used was 1,123 KRW per USD (2017 June). CONCLUSIONS: At a suggested threshold around 1GDP, treating of HFrEF patients with sacubitril/Valsartan versus Enalapril is cost-effective from health-care perspective in Korea.
Conference/Value in Health Info
2017-11, ISPOR Europe 2017, Glasgow, Scotland
Value in Health, Vol. 20, No. 9 (October 2017)
Code
PCV96
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Cardiovascular Disorders