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Model parameters influencing the cost-effectiveness of sacubitril/valsartan in heart failure: evidence from a systematic literature review

Author

Listed:
  • Clare Proudfoot

    (Novartis Pharma AG)

  • Raju Gautam

    (Novartis Healthcare Pvt. Ltd.)

  • Joaquim Cristino

    (Novartis Pharmaceuticals Corporation)

  • Rumjhum Agrawal

    (Novartis Healthcare Pvt. Ltd.)

  • Lalit Thakur

    (Novartis Healthcare Pvt. Ltd.)

  • Keith Tolley

    (Tolley Health Economics Ltd.)

Abstract

Objectives To summarize cost-effectiveness (CE) evidence of sacubitril/valsartan for the treatment of heart failure (HF) patients with reduced ejection fraction (HFrEF). The impact of different modeling approaches and parameters on the CE results is also described. Methods We conducted a systematic literature review using multiple databases: Embase®; MEDLINE®; MEDLINE®-In Process; NIHR CRD database including DARE, NHS EED, and HTA databases; and the Cost Effectiveness Analysis registry. We also reviewed HTA countries’ websites to identify CE reports of sacubitril/valsartan, published up to 25-July-2021. Articles published in English as full-texts, conference-abstracts, or HTA reports were included. Results We included 44 CE models [39 from 37 publications (22 full-texts; 15 conference-abstracts) and 5 HTAs; Europe, n = 20; North and South Americas, n = 14; Asia and Australia, n = 10]. Most models adopted a Markov structure with constant transition probabilities of events (n = 27) or a mix of Markov and regression-based models (n = 16), with variations in structural assumptions and chosen parameters. Study authors concluded sacubitril/valsartan to be a cost-effective therapy in 37/41 models in chronic HFrEF patients and 2/3 models in hospitalized patients stabilized after an acute decompensation for HF. CE models showing sacubitril/valsartan not to be a cost-effective treatment generally modeled a shorter time horizon. Effect of sacubitril/valsartan on cardiovascular and all-cause mortality, cost, duration of effect and time horizon was the main model drivers. Conclusions Most evidence indicated sacubitril/valsartan is cost-effective in HFrEF. The use of a lifetime horizon is recommended in future models as HF is a chronic disease. Data on the CE of sacubitril/valsartan in the inpatient setting were limited and further research is warranted.

Suggested Citation

  • Clare Proudfoot & Raju Gautam & Joaquim Cristino & Rumjhum Agrawal & Lalit Thakur & Keith Tolley, 2023. "Model parameters influencing the cost-effectiveness of sacubitril/valsartan in heart failure: evidence from a systematic literature review," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(3), pages 453-467, April.
  • Handle: RePEc:spr:eujhec:v:24:y:2023:i:3:d:10.1007_s10198-022-01485-3
    DOI: 10.1007/s10198-022-01485-3
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    References listed on IDEAS

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    1. Gian Luca Di Tanna & Anna Bychenkova & Frank O’Neill & Heidi S. Wirtz & Paul Miller & Briain Ó Hartaigh & Gary Globe, 2019. "Evaluating Cost-Effectiveness Models for Pharmacologic Interventions in Adults with Heart Failure: A Systematic Literature Review," PharmacoEconomics, Springer, vol. 37(3), pages 359-389, March.
    2. Afschin Gandjour & Dennis A. Ostwald, 2018. "Sacubitril/Valsartan (LCZ696): A Novel Treatment for Heart Failure and its Estimated Cost Effectiveness, Budget Impact, and Disease Burden Reduction in Germany," PharmacoEconomics, Springer, vol. 36(10), pages 1285-1296, October.
    3. Gian Luca Di Tanna & Shuxian Chen & Anna Bychenkova & Heidi S. Wirtz & Karen L. Burrows & Gary Globe, 2020. "Economic Evaluations of Pharmacological Treatments in Heart Failure Patients: A Methodological Review with a Focus on Key Model Drivers," PharmacoEconomics - Open, Springer, vol. 4(3), pages 397-401, September.
    4. Gerardus Frederix & Johan Hasselt & Jan Schellens & Anke Hövels & Jan Raaijmakers & Alwin Huitema & Johan Severens, 2014. "The Impact of Structural Uncertainty on Cost-Effectiveness Models for Adjuvant Endocrine Breast Cancer Treatments: the Need for Disease-Specific Model Standardization and Improved Guidance," PharmacoEconomics, Springer, vol. 32(1), pages 47-61, January.
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    7. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    More about this item

    Keywords

    Cost-effectiveness; Economic model; Heat failure; Sacubitril/valsartan; Sensitivity analysis;
    All these keywords.

    JEL classification:

    • C00 - Mathematical and Quantitative Methods - - General - - - General

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