Cost-Effectiveness of Sacubitril/Valsartan Compared with Enalapril in Patients with Heart Failure with Reduced Ejection Fraction: A Systematic Review.
Cost-effectiveness analysis
Heart failure, epidemiology
Heart failure, therapy
Sacubitril-valsartan
Systematic review
Journal
The journal of Tehran Heart Center
ISSN: 1735-5370
Titre abrégé: J Tehran Heart Cent
Pays: Iran
ID NLM: 101289255
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
received:
08
09
2022
accepted:
02
10
2022
medline:
5
5
2023
pubmed:
5
5
2023
entrez:
5
5
2023
Statut:
ppublish
Résumé
To assess the cost-effectiveness of sacubitril/valsartan compared with enalapril in patients with heart failure with reduced ejection (HFrEF). A systematic literature search was conducted searching in major electronic databases from inception to January 1, 2021. All relevant full economic evaluation studies of sacubitril/valsartan versus enalapril for the treatment of patients with HFrEF were identified using ad hoc search strategies. Mortality, hospital admissions, quality-adjusted life years (QALYs), life-years (LYQs), annual drug costs, total lifetime costs, and incremental cost-effectiveness ratio (ICER) were considered as the outcomes. The quality of the included studies was assessed using the CHEERS checklist. This study was conducted and reported in accordance with the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. The initial search yielded a pool of 1026 articles, of which 703 unique articles were screened, 65 full-text articles were assessed for eligibility and 15 studies finally included in the qualitative synthesis. Studies show that sacubitril/valsartan reduces mortality and hospitalization rate. The mean of death risk ratio and hospitalization were computed at 0.843 and 0.844, respectively. Sacubitril/valsartan produced higher annual and total lifetime costs. The lowest and highest lifetime costs for sacubitril/valsartan were found in Thailand ($4,756) and Germany ($118,815), respectively. The lowest ICER was reported in Thailand ($4857/QALY) and the highest in the USA ($143,891/QALY). Sacubitril/valsartan is associated with better outcomes and may be cost-effective compared to enalapril for the management of HFrEF. However, in developing countries such as Thailand, sacubitril-valsartan costs must be reduced to yield an ICER below the threshold.
Sections du résumé
Background
UNASSIGNED
To assess the cost-effectiveness of sacubitril/valsartan compared with enalapril in patients with heart failure with reduced ejection (HFrEF).
Methods
UNASSIGNED
A systematic literature search was conducted searching in major electronic databases from inception to January 1, 2021. All relevant full economic evaluation studies of sacubitril/valsartan versus enalapril for the treatment of patients with HFrEF were identified using ad hoc search strategies. Mortality, hospital admissions, quality-adjusted life years (QALYs), life-years (LYQs), annual drug costs, total lifetime costs, and incremental cost-effectiveness ratio (ICER) were considered as the outcomes. The quality of the included studies was assessed using the CHEERS checklist. This study was conducted and reported in accordance with the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines.
Results
UNASSIGNED
The initial search yielded a pool of 1026 articles, of which 703 unique articles were screened, 65 full-text articles were assessed for eligibility and 15 studies finally included in the qualitative synthesis. Studies show that sacubitril/valsartan reduces mortality and hospitalization rate. The mean of death risk ratio and hospitalization were computed at 0.843 and 0.844, respectively. Sacubitril/valsartan produced higher annual and total lifetime costs. The lowest and highest lifetime costs for sacubitril/valsartan were found in Thailand ($4,756) and Germany ($118,815), respectively. The lowest ICER was reported in Thailand ($4857/QALY) and the highest in the USA ($143,891/QALY).
Conclusion
UNASSIGNED
Sacubitril/valsartan is associated with better outcomes and may be cost-effective compared to enalapril for the management of HFrEF. However, in developing countries such as Thailand, sacubitril-valsartan costs must be reduced to yield an ICER below the threshold.
Identifiants
pubmed: 37143752
doi: 10.18502/jthc.v17i4.11603
pii: JTHC-17-168
pmc: PMC10154110
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
168-179Informations de copyright
Copyright © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.
Références
Ann Intern Med. 2009 Aug 18;151(4):264-9, W64
pubmed: 19622511
Value Health. 2017 Dec;20(10):1260-1269
pubmed: 29241885
N Engl J Med. 1991 Aug 1;325(5):293-302
pubmed: 2057034
Pharmacotherapy. 2018 May;38(5):520-530
pubmed: 29601093
Eur J Heart Fail. 2016 Aug;18(8):891-975
pubmed: 27207191
Pharmacoeconomics. 2018 Oct;36(10):1285-1296
pubmed: 30054868
N Engl J Med. 2014 Sep 11;371(11):993-1004
pubmed: 25176015
Value Health. 2017 Mar;20(3):388-396
pubmed: 28292483
Swiss Med Wkly. 2017 Nov 29;147:w14533
pubmed: 29185253
Eur J Heart Fail. 2002 Jun;4(3):361-71
pubmed: 12034163
J Med Econ. 2018 Feb;21(2):174-181
pubmed: 28959905
JACC Heart Fail. 2016 May;4(5):392-402
pubmed: 27039128
Nat Rev Cardiol. 2011 Jan;8(1):30-41
pubmed: 21060326
Value Health. 2019 Oct;22(10):1119-1127
pubmed: 31563254
J Med Econ. 2018 Dec;21(12):1145-1147
pubmed: 30033833
Cost Eff Resour Alloc. 2013 Mar 25;11(1):6
pubmed: 23531194
Expert Rev Pharmacoecon Outcomes Res. 2020 Apr;20(2):199-205
pubmed: 31219361
Heart Lung Circ. 2020 Sep;29(9):1310-1317
pubmed: 32303468
Circ Res. 2013 Aug 30;113(6):646-59
pubmed: 23989710
Heart. 2018 Jun;104(12):1006-1013
pubmed: 29269379
Circulation. 2011 Mar 1;123(8):933-44
pubmed: 21262990
Circulation. 2015 Jan 27;131(4):e29-322
pubmed: 25520374
Heart Fail Rev. 2021 Sep;26(5):1119-1130
pubmed: 32405811
Pharmacoeconomics. 2015 Mar;33(3):205-24
pubmed: 25377850
Am J Cardiovasc Drugs. 2018 Oct;18(5):405-413
pubmed: 29926351
Am J Cardiol. 1988 Jul 11;62(2):60A-66A
pubmed: 2839019
JAMA Cardiol. 2016 Sep 1;1(6):666-72
pubmed: 27438344
Value Health. 2013 Mar-Apr;16(2):231-50
pubmed: 23538175
Clin Ther. 2019 Jun;41(6):1066-1079
pubmed: 31101372
Eur J Prev Cardiol. 2021 Aug 9;28(9):966-972
pubmed: 34402869