Sacubitril/Valsartan for Heart Failure with Preserved Ejection Fraction: A Cost-Effectiveness Analysis from the Perspective of the Chinese Healthcare System

作者全名："Wang, Zhe; Lou, Yake; Wang, Qi; Sun, Min; Li, Xiaonan; Wang, Yinghui; Wang, Yuehui"

作者地址："[Wang, Zhe; Wang, Qi; Sun, Min; Li, Xiaonan; Wang, Yinghui; Wang, Yuehui] First Hosp Jilin Univ, Dept Geriatr, Changchun 130021, Jilin, Peoples R China; [Lou, Yake] Chongqing Med Univ, Affiliated Hosp 2, Dept Cardiol, Chongqing 400010, Peoples R China"

通信作者："Wang, YH (通讯作者)，First Hosp Jilin Univ, Dept Geriatr, Changchun 130021, Jilin, Peoples R China."

来源：CLINICAL DRUG INVESTIGATION

ESI学科分类：PHARMACOLOGY & TOXICOLOGY

WOS号：WOS:000956406700001

JCR分区：Q2

影响因子：2.9

年份：2023

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期号：　

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结束页：　

文献类型：Article; Early Access

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摘要："Background and ObjectivesSacubitril/valsartan has shown effectiveness in reducing hospitalization compared with valsartan in HFpEF patients with heart failure with preserved ejection fraction (HFpEF).We aimed to investigate the cost effectiveness of sacubitril/valsartan as an alternative to valsartan in Chinese patients with heart failure with HFpEF.MethodsA Markov model was built to investigate the cost effectiveness of sacubitril/valsartan as an alternative to valsartan in Chinese patients with HFpEF, from the healthcare system perspective. The time horizon was a lifetime, with a cycle length of 1 month. Costs were obtained from local information or published papers, discounted at a rate of 0.05 for future costs. The transition probability and utility were based on other studies. The primary outcome of the study was the incremental cost-effectiveness ratio (ICER). Sacubitril/valsartan was considered cost effective if the ICER obtained was lower than the willingness-to-pay threshold of US dollars (US$) 12,551.5 per quality-adjusted life-year (QALY). One-way and probabilistic sensitivity analyses, as well as scenario analysis, were performed to test robustness.ResultsOver a lifetime simulation, a 73-year-old Chinese patient with HFpEF could gain 6.44 QALYs (9.15 life-years) if sacubitril/valsartan plus standard treatment was administered, and 6.37 QALYs (9.07 life-years) if valsartan plus standard treatment was prescribed. The corresponding costs in both groups were US$12,471 and US$8663, respectively. The ICER was US$49,019/QALY (US$46,610/life-year), higher than the willingness-to-pay threshold. Sensitivity analyses and scenario analysis showed that our results were robust.ConclusionAdding sacubitril/valsartan to standard treatment as an alternative to valsartan for the treatment of HFpEF resulted in more effectiveness but higher costs. Sacubitril/valsartan was likely to not be cost effective in Chinese patients with HFpEF. The cost of sacubitril/valsartan needs to reduce to 34% of its current price to be cost effective in this population. Studies based on real-world data are needed to confirm our conclusions."

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