LI Feng,HE Mei,MU Lifeng,et al.Study on pharmacoeconomic evaluation of vericiguat in the treatment of heart failure with reduced ejection fraction[J].ZHONGGUO YAOFANG,2023,34(15):1869-1873.
LI Feng,HE Mei,MU Lifeng,et al.Study on pharmacoeconomic evaluation of vericiguat in the treatment of heart failure with reduced ejection fraction[J].ZHONGGUO YAOFANG,2023,34(15):1869-1873. DOI: 10.6039/j.issn.1001-0408.2023.15.15.
Study on pharmacoeconomic evaluation of vericiguat in the treatment of heart failure with reduced ejection fraction
To evaluate the cost-effectiveness of vericiguat combined with standard treatment in the treatment of heart failure with reduced ejection fraction (HFrEF).
METHODS
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Based on the results of the VICTORIA trial and related literature, a three-state (including stable state of heart failure, hospitalized state of heart failure and death state) Markov model was constructed. The cycle length was 1 month, the time horizon was 20 years, the discount rate was 5%, and one time China’s per capita gross domestic product (GDP) in 2021 was the willing-to-pay (WTP) threshold. Cost-utility analysis was performed to evaluate the cost-effectiveness of vericiguat combined with standard treatment in the treatment of HFrEF. The output indicators included quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER). The robustness of the results of the basic analysis was verified by one-way sensitivity analysis and probability sensitivity analysis.
RESULTS
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The ICER of vericiguat combined with the standard treatment plan compared to the standard treatment plan alone was 444 341.95 yuan/QALY, which was more than WTP of this study (80 976 yuan/QALY). One-way sensitivity analyses showed that the probability of cardiovascular death in both groups was the main influencing parameter for the robustness of the model, but they had little influence on the results of the basic analysis. The probabilistic sensitivity analysis displayed that under the WTP threshold of this study, the possibility of vericiguat combined with the standard treatment plan being more cost-effective was 2.6%.
CONCLUSIONS
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Compared with the standard treatment plan, vericiguat combined with the standard treatment plan is not cost-effective in patients with HFrEF.
SAVARESE G,LUND L H. Global public health burden of heart failure[J]. Card Fail Rev,2017,3(1):7-11.
HEIDENREICH P A,ALBERT N M,ALLEN L A,et al. Forecasting the impact of heart failure in the United States:a policy statement from the American Heart Association[J]. Circ Heart Fail,2013,6(3):606-619.
HAO G,WANG X,CHEN Z,et al. Prevalence of heart failure and left ventricular dysfunction in China:the China Hypertension Survey,2012-2015[J]. Eur J Heart Fail,2019,21(11):1329-1337.
COOK C,COLE G,ASARIA P,et al. The annual global economic burden of heart failure[J]. Int J Cardiol,2014,171(3):368-376.
HUANG J,YIN H J,ZHANG M L,et al. Understanding the economic burden of heart failure in China:impact on disease management and resource utilization[J]. J Med Econ,2017,20(5):549-553.
LAWSON C A,ZACCARDI F,SQUIRE I,et al. 20-year trends in cause-specific heart failure outcomes by sex,socioeconomic status,and place of diagnosis:a population-based study[J]. Lancet Public Health,2019,4(8):e406-e420.
COWIE M R,ANKER S D,CLELAND J G F,et al. Improving care for patients with acute heart failure:before,during and after hospitalization[J]. ESC Heart Fail,2014,1(2):110-145.
MARKHAM A,DUGGAN S. Vericiguat:first approval[J]. Drugs,2021,81(6):721-726.
ARMSTRONG P W,PIESKE B,ANSTROM K J,et al. Vericiguat in patients with heart failure and reduced ejection fraction[J]. N Engl J Med,2020,382(20):1883-1893.
HEIDENREICH P A,BOZKURT B,AGUILAR D,et al. 2022 AHA/ACC/HFSA guideline for the management of heart failure:a report of the American College of Cardio- logy/American Heart Association joint committee on clinical practice guidelines[J]. J Am Coll Cardiol,2022,79(17):e263-e421.
CHAN D C,HEIDENREICH P A,WEINSTEIN M C,et al. Heart failure disease management programs:a cost-effectiveness analysis[J]. Am Heart J,2008,155(2):332-338.
KRITTAYAPHONG R,PERMSUWAN U. Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction[J]. Int J Cardiol,2021,322:183-190.
GIDWANI R,RUSSELL L B. Estimating transition pro- babilities from published evidence:a tutorial for decision modelers[J]. PharmacoEconomics,2020,38(11):1153-1164.
HONG S H,LEE J Y,PARK S K,et al. The utility of 5 hypothetical health states in heart failure using time trade-off (TTO) and EQ-5D-5L in Korea[J]. Clin Drug Investig,2018,38(8):727-736.
刘国恩. 中国药物经济学评价指南2020[M]. 北京:中国市场出版社,2020:28.
CAI D,SHI S,JIANG S,et al. Estimation of the cost-effective threshold of a quality-adjusted life year in China based on the value of statistical life[J]. Eur J Health Econ,2022,23(4):607-615.
OCHALEK J,WANG H Y,GU Y Y,et al. Informing a cost-effectiveness threshold for health technology assessment in China:a marginal productivity approach[J]. Pharmacoeconomics,2020,38(12):1319-1331.