IDEAS home Printed from https://ideas.repec.org/a/spr/pharme/v40y2022i12d10.1007_s40273-022-01182-2.html
   My bibliography  Save this article

Cost Effectiveness of the First‐in‐Class ARNI (Sacubitril/Valsartan) for the Treatment of Essential Hypertension in a Chinese Setting

Author

Listed:
  • Xinyue Dong

    (Tianjin University
    Tianjin University)

  • Xiaoning He

    (Tianjin University
    Tianjin University)

  • Jing Wu

    (Tianjin University
    Tianjin University)

Abstract

Objective The aim of this study was to model the potential long-term disease progression and pharmacoeconomic value of sacubitril/valsartan for the treatment of essential hypertension from a Chinese healthcare system perspective. Methods A Markov cohort model with five health states was constructed to simulate the incidence of acute cardiovascular events and cost per quality-adjusted life-year (QALY) gained with sacubitril/valsartan compared with allisartan isoproxil and valsartan over a lifetime horizon with an annual cycle. Multivariable risk regression models derived from China-PAR data accompanied by hazard ratios were used to transform the dual mechanism of sacubitril/valsartan to lower blood pressure and left ventricular mass index into long-term fatal and non-fatal cardiovascular risks. Efficacy data were calculated using a network meta-analysis integrated by the results of clinical trials. Healthcare costs were determined from a real-world study and published literature, supplemented by expert opinion. Utilities were derived from literature. Both costs and health outcomes were discounted at 5.0% annually, and prices corresponded to 2021. Model validation, deterministic and probabilistic sensitivity analyses were conducted to test the robustness of results. Results For simulated patients with hypertension, sacubitril/valsartan reduced the rates of myocardial infarction by 6.67% and 6.39%, stroke by 9.38% and 8.98%, and heart failure hospitalization by 9.92% and 9.62% relative to allisartan isoproxil and valsartan, respectively. It was also associated with gains in life expectancy among hypertensive individuals of 0.362–0.382 years. Eventually, lifetime costs per patient were CN¥59,272 (US$9187) for sacubitril/valsartan, CN¥54,783 (US$8492) for allisartan isoproxil, and CN¥56,714 (US$8791) for valsartan; total QALYs were 11.38, 11.24, and 11.25, respectively. The incremental cost-effectiveness ratio was CN¥31,805/QALY (US$4930/QALY) compared with allisartan isoproxil, and CN¥19,247/QALY (US$2983/QALY) compared with valsartan, both of which are below the one time per-capita GDP of CN¥80,976/QALY (US$12,551/QALY) in China. Similar results were obtained in various extensive sensitivity analysis scenarios. Conclusions This was the first study to evaluate the cost effectiveness of sacubitril/valsartan in the treatment of hypertension. Sacubitril/valsartan compares favorably with allisartan isoproxil and valsartan in the Chinese setting, which is mainly due to its higher efficacy resulting in fewer cardiovascular events and ultimately less related mortality over time. The results could inform deliberations regarding reimbursement and access to this treatment in China and may provide reference for facilitating more reasonable and efficient allocation of limited resources in such low- and middle-income countries.

Suggested Citation

  • Xinyue Dong & Xiaoning He & Jing Wu, 2022. "Cost Effectiveness of the First‐in‐Class ARNI (Sacubitril/Valsartan) for the Treatment of Essential Hypertension in a Chinese Setting," PharmacoEconomics, Springer, vol. 40(12), pages 1187-1205, December.
    • Handle: RePEc:spr:pharme:v:40:y:2022:i:12:d:10.1007_s40273-022-01182-2
    DOI: 10.1007/s40273-022-01182-2
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40273-022-01182-2
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40273-022-01182-2?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Chiranjeev Sanyal & Don Husereau, 2020. "Systematic Review of Economic Evaluations of Services Provided by Community Pharmacists," Applied Health Economics and Health Policy, Springer, vol. 18(3), pages 375-392, June.
    2. Arantzazu Arrospide & Oliver Ibarrondo & Iván Castilla & Igor Larrañaga & Javier Mar, 2022. "Development and Validation of a Discrete Event Simulation Model to Evaluate the Cardiovascular Impact of Population Policies for Obesity," Medical Decision Making, , vol. 42(2), pages 241-254, February.
    3. Mark Oppe & Daniela Ortín-Sulbarán & Carlos Vila Silván & Anabel Estévez-Carrillo & Juan M. Ramos-Goñi, 2021. "Cost-effectiveness of adding Sativex® spray to spasticity care in Belgium: using bootstrapping instead of Monte Carlo simulation for probabilistic sensitivity analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 711-721, July.
    4. Kaitlyn Hastings & Clara Marquina & Jedidiah Morton & Dina Abushanab & Danielle Berkovic & Stella Talic & Ella Zomer & Danny Liew & Zanfina Ademi, 2022. "Projected New-Onset Cardiovascular Disease by Socioeconomic Group in Australia," PharmacoEconomics, Springer, vol. 40(4), pages 449-460, April.
    5. Andrea Marcellusi & Raffaella Viti & Loreta A. Kondili & Stefano Rosato & Stefano Vella & Francesco Saverio Mennini, 2019. "Economic Consequences of Investing in Anti-HCV Antiviral Treatment from the Italian NHS Perspective: A Real-World-Based Analysis of PITER Data," PharmacoEconomics, Springer, vol. 37(2), pages 255-266, February.
    6. Risha Gidwani & Louise B. Russell, 2020. "Estimating Transition Probabilities from Published Evidence: A Tutorial for Decision Modelers," PharmacoEconomics, Springer, vol. 38(11), pages 1153-1164, November.
    7. Round, Jeff, 2012. "Is a QALY still a QALY at the end of life?," Journal of Health Economics, Elsevier, vol. 31(3), pages 521-527.
    8. Joseph F. Levy & Marjorie A. Rosenberg, 2019. "A Latent Class Approach to Modeling Trajectories of Health Care Cost in Pediatric Cystic Fibrosis," Medical Decision Making, , vol. 39(5), pages 593-604, July.
    9. Jisoo A Kwon & Georgina M Chambers & Fabio Luciani & Lei Zhang & Shamin Kinathil & Dennis Kim & Hla-Hla Thein & Willings Botha & Sandra Thompson & Andrew Lloyd & Lorraine Yap & Richard T Gray & Tony B, 2021. "Hepatitis C treatment strategies in prisons: A cost-effectiveness analysis," PLOS ONE, Public Library of Science, vol. 16(2), pages 1-13, February.
    10. Qi Cao & Erik Buskens & Hans L. Hillege & Tiny Jaarsma & Maarten Postma & Douwe Postmus, 2019. "Stratified treatment recommendation or one-size-fits-all? A health economic insight based on graphical exploration," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(3), pages 475-482, April.
    11. Jorge Luis García & James J. Heckman, 2021. "Early childhood education and life‐cycle health," Health Economics, John Wiley & Sons, Ltd., vol. 30(S1), pages 119-141, November.
    12. Stephen Morris & Kurinchi S Gurusamy & Jessica Sheringham & Brian R Davidson, 2015. "Cost-Effectiveness Analysis of Endoscopic Ultrasound versus Magnetic Resonance Cholangiopancreatography in Patients with Suspected Common Bile Duct Stones," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-12, March.
    13. Tushar Srivastava & Nicholas R. Latimer & Paul Tappenden, 2021. "Estimation of Transition Probabilities for State-Transition Models: A Review of NICE Appraisals," PharmacoEconomics, Springer, vol. 39(8), pages 869-878, August.
    14. Eleanor Heather & Katherine Payne & Mark Harrison & Deborah Symmons, 2014. "Including Adverse Drug Events in Economic Evaluations of Anti-Tumour Necrosis Factor-α Drugs for Adult Rheumatoid Arthritis: A Systematic Review of Economic Decision Analytic Models," PharmacoEconomics, Springer, vol. 32(2), pages 109-134, February.
    15. Manuel Gomes & Robert Aldridge & Peter Wylie & James Bell & Owen Epstein, 2013. "Cost-Effectiveness Analysis of 3-D Computerized Tomography Colonography Versus Optical Colonoscopy for Imaging Symptomatic Gastroenterology Patients," Applied Health Economics and Health Policy, Springer, vol. 11(2), pages 107-117, April.
    16. Isaac Corro Ramos & Maureen P. M. H. Rutten-van Mölken & Maiwenn J. Al, 2013. "The Role of Value-of-Information Analysis in a Health Care Research Priority Setting," Medical Decision Making, , vol. 33(4), pages 472-489, May.
    17. Chantal Guilhaume & Delphine Saragoussi & John Cochran & Clément François & Mondher Toumi, 2010. "Modeling stroke management: a qualitative review of cost-effectiveness analyses," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 419-426, August.
    18. Theresa Tawiah & Kristian Schultz Hansen & Frank Baiden & Jane Bruce & Mathilda Tivura & Rupert Delimini & Seeba Amengo-Etego & Daniel Chandramohan & Seth Owusu-Agyei & Jayne Webster, 2016. "Cost-Effectiveness Analysis of Test-Based versus Presumptive Treatment of Uncomplicated Malaria in Children under Five Years in an Area of High Transmission in Central Ghana," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-18, October.
    19. F. S. Mennini & Gianluca Fabiano & G. Favato & P. Sciattella & P. Bonanni & C. Pinto & A. Marcellusi, 2019. "Economic burden of HPV9-related diseases: a real-world cost analysis from Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(6), pages 829-840, August.
    20. Wei Fang & Zhenru Wang & Michael B. Giles & Chris H. Jackson & Nicky J. Welton & Christophe Andrieu & Howard Thom, 2022. "Multilevel and Quasi Monte Carlo Methods for the Calculation of the Expected Value of Partial Perfect Information," Medical Decision Making, , vol. 42(2), pages 168-181, February.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:pharme:v:40:y:2022:i:12:d:10.1007_s40273-022-01182-2. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.