Pharmacoeconomic evaluation of finerenone combined with standard regimen in the treatment of heart failure with preserved or mildly reduced ejection fraction

XIA Runan; WANG Xu; CHEN Huijuan; JIANG Mengyu; DI Panpan; ZHAO Mengmeng; LIU Li; LIANG Hai

doi:10.6039/j.issn.1001-0408.2025.14.14

您当前的位置：

首页 >

文章列表页 >

Pharmacoeconomic evaluation of finerenone combined with standard regimen in the treatment of heart failure with preserved or mildly reduced ejection fraction

更新时间：2025-09-24

- Pharmacoeconomic evaluation of finerenone combined with standard regimen in the treatment of heart failure with preserved or mildly reduced ejection fraction
- ZHONGGUO YAOFANG Vol. 36, Issue 14, Pages: 1770-1774(2025)
- 作者机构：
  
  亳州市人民医院药学部，安徽亳州　236800
- 作者简介：
- 基金信息：
- DOI：10.6039/j.issn.1001-0408.2025.14.14
  CLC： R956
- Received：08 March 2025，
  
  Revised：2025-06-26，
  
  Accepted：26 June 2025，
  
  Published：30 July 2025
- 稿件说明：
移动端阅览
夏茹楠,王旭,陈慧娟,等.非奈利酮联合标准方案治疗射血分数轻度降低型或保留型心力衰竭的药物经济学评价[J].中国药房,2025,36(14):1770-1774.

XIA Runan,WANG Xu,CHEN Huijuan,et al.Pharmacoeconomic evaluation of finerenone combined with standard regimen in the treatment of heart failure with preserved or mildly reduced ejection fraction[J].ZHONGGUO YAOFANG,2025,36(14):1770-1774.
夏茹楠,王旭,陈慧娟,等.非奈利酮联合标准方案治疗射血分数轻度降低型或保留型心力衰竭的药物经济学评价[J].中国药房,2025,36(14):1770-1774. DOI： 10.6039/j.issn.1001-0408.2025.14.14.

XIA Runan,WANG Xu,CHEN Huijuan,et al.Pharmacoeconomic evaluation of finerenone combined with standard regimen in the treatment of heart failure with preserved or mildly reduced ejection fraction[J].ZHONGGUO YAOFANG,2025,36(14):1770-1774. DOI： 10.6039/j.issn.1001-0408.2025.14.14.

摘要

目的

对非奈利酮联合标准治疗方案（SoC）治疗射血分数轻度降低型心力衰竭（HFmrEF）或射血分数保留型心力衰竭（HFpEF）的经济性进行评价。

方法

基于一项Ⅲ期临床试验，从我国卫生体系角度出发，建立非奈利酮联合SoC方案和SoC方案治疗HFmrEF/HFpEF的不同心功能状态的Markov模型。以质量调整生命年（QALY）为健康产出指标，以3倍我国2023年人均国内生产总值作为意愿支付（WTP）阈值，设置模型周期为3个月、模拟时限为10年、贴现率为5%，模拟非奈利酮联合SoC和SoC治疗HFmrEF/HFpEF各个阶段的动态变化，获得两种治疗方案的长期效果与成本，并进行单因素敏感性分析和概率敏感性分析以检验结果的稳健性。

结果

非奈利酮联合SoC方案相比SoC方案的增量成本-效果比为179 504.75元/QALY，小于本研究设定的WTP阈值，表明非奈利酮联合SoC方案具有一定的经济性优势。单因素敏感性分析结果显示，NYHA Ⅱ状态的效用值、非奈利酮的药品价格、贴现率以及两组的住院转移概率对结果的影响较大，但未影响模型的稳健性。概率敏感性分析也验证了模型的稳健性。

结论

在本研究设定的WTP阈值下，非奈利酮联合SoC治疗HFmrEF/HFpEF相较于SoC更具有经济性。

Abstract

OBJECTIVE

To evaluate the cost-effectiveness of finerenone combined with standard of care （SoC） in the treatment of heart failure with mildly reduced ejection fraction （HFmrEF） or preserved ejection fraction （HFpEF）.

METHODS

Based on a phase Ⅲ clinical trial， a Markov model was constructed from the perspective of China’s healthcare system to compare the treatment outcomes of finerenone combined with SoC regimen versus SoC regimen alone in the treatment of different cardiac functional statuses of HFmrEF/HFpEF. Using quality-adjusted life year （QALY） as the health output index， 3 times China’s per capita GDP in 2023 as the willingness-to-pay （WTP） threshold， a simulation was conducted with a 3-month cycle length and a 10-year time horizon， incorporating an annual discount rate of 5%. The dynamic changes across various stages of HFmrEF/HFpEF treated with finerenone combined with SoC versus SoC alone were simulated to evaluate the long-term effectiveness and costs of the two treatment strategies. Additionally， one-way sensitivity analysis and probabilistic sensitivity analysis were performed， to test the robustness of the results.

RESULTS

The incremental cost-effectiveness ratio （ICER） of the finerenone combined with SoC regimen versus SoC regimen alone was 179 504.75 yuan/QALY， which was below the WTP threshold set in this study， indicating that the finerenone combined with SoC regimen possessed certain economic advantages. The results of one-way sensitivity analysis showed that the utility value of NYHA Ⅱ status， the drug price of finerenone， the discount rate， and the probability of hospital transfer for both groups had a great influence on ICER， but did not affect the robustness of the model. The probabilistic sensitivity analysis also confirmed the robustness of the model.

CONCLUSIONS

Under the WTP threshold set in this study， finerenone combined with SoC is cost-effective in the treatment of HFmrEF/HFpEF， compared with the SoC regimen.

关键词

Keywords

references

GBD 2016 Disease and Injury Incidence and Prevalence Collaborators . Global，regional，and national incidence，prevalence，and years lived with disability for 328 diseases and injuries for 195 countries，1990-2016：a systematic analysis for the Global Burden of Disease Study 2016 [J ] . Lancet ， 2017 ， 390 （ 10100 ）： 1211 - 1259 .

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 .

ZIAEIAN B ， FONAROW G C . Epidemiology and aetio-logy of heart failure [J ] . Nat Rev Cardiol ， 2016 ， 13 （ 6 ）： 368 - 378 .

国家心血管病医疗质量控制中心专家委员会心力衰竭专家工作组 . 2020中国心力衰竭医疗质量控制报告 [J ] . 中国循环杂志， 2021 ， 36 （ 3 ）： 221 - 238 .

中华医学会心血管病学分会，中国医师协会心血管内科医师分会，中国医师协会心力衰竭专业委员会，等 . 中国心力衰竭诊断和治疗指南2024 [J ] . 中华心血管病杂志， 2024 ， 52 （ 3 ）： 235 - 275 .

JHUND P S ， TALEBI A ， HENDERSON A D ， et al . Min-eralocorticoid receptor antagonists in heart failure：an individual patient level meta-analysis [J ] . Lancet ， 2024 ， 404 （ 10458 ）： 1119 - 1131 .

林莹，唐丽丹 . 新型盐皮质激素受体拮抗剂：非奈利酮 [J ] . 中国新药与临床杂志， 2022 ， 41 （ 12 ）： 729 - 732 .

LIMA-POSADA I ， STEPHAN Y ， SOULIÉ M ， et al . Benefits of the non-steroidal mineralocorticoid receptor antagonist finerenone in metabolic syndrome-related heart failure with preserved ejection fraction [J ] . Int J Mol Sci ， 2023 ， 24 （ 3 ）： 2536 .

SOLOMON S D ， MCMURRAY J J V ， VADUGANATHAN M ， et al . Finerenone in heart failure with mildly reduced or preserved ejection fraction [J ] . N Engl J Med ， 2024 ， 391 （ 16 ）： 1475 - 1485 .

CONRAD N ， JUDGE A ， TRAN J ， et al . Temporal trends and patterns in heart failure incidence：a population-based study of 4 million individuals [J ] . Lancet ， 2018 ， 391 （ 10120 ）： 572 - 580 .

梁海，夏茹楠，狄潘潘，等 . 非奈利酮联合标准方案治疗糖尿病肾病的药物经济学评价 [J ] . 中国药房， 2025 ， 36 （ 1 ）： 86 - 90 .

QUIST S W ， VAN SCHOONHOVEN A V ， BAKKER S J L ， et al . Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in the Netherlands [J ] . Cardiovasc Diabetol ， 2023 ， 22 （ 1 ）： 328 .

YAO Y N ， ZHANG R C ， AN T ， et al . Cost-effectiveness of adding dapagliflozin to standard treatment for heart fai-lure with reduced ejection fraction patients in China [J ] . ESC Heart Fail ， 2020 ， 7 （ 6 ）： 3582 - 3592 .

LOU Y K ， HU T Y ， HUANG J . Cost-effectiveness of adding empagliflozin to standard treatment for heart failure with preserved ejection fraction patients in China [J ] . Am J Cardiovasc Drugs ， 2023 ， 23 （ 1 ）： 47 - 57 .

GREENE S J ， FONAROW G C ， VADUGANATHAN M ， et al . The vulnerable phase after hospitalization for heart failure [J ] . Nat Rev Cardiol ， 2015 ， 12 （ 4 ）： 220 - 229 .

CLELAND J G F ， DAUBERT J C ， ERDMANN E ， et al . The effect of cardiac resynchronization on morbidity and mortality in heart failure [J ] . N Engl J Med ， 2005 ， 352 （ 15 ）： 1539 - 1549 .

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 .

ZHENG C L ， WU J N ， LI N ， et al . Cost-effectiveness of finerenone added to standard of care for patients with type 2 diabetes-related chronic kidney disease in the United States [J ] . Diabetes Obes Metab ， 2025 ， 27 （ 1 ）： 165 - 173 .

宣建伟，朱水清，王韶屏，等 . 我国一线城市心力衰竭患者住院费用调查及其影响因素分析 [J ] . 中国医疗保险， 2017 （ 12 ）： 52 - 56 .

TANG Y ， SANG H Q . Cost-utility analysis of add-on dapagliflozin in heart failure with preserved or mildly reduced ejection fraction [J ] . ESC Heart Fail ， 2023 ， 10 （ 4 ）： 2524 - 2533 .

PEI H ， WANG W ， ZHAO D ， et al . The use of a novel non-steroidal mineralocorticoid receptor antagonist finerenone for the treatment of chronic heart failure：a systematic review and meta-analysis [J ] . Medicine（Baltimore）， 2018 ， 97 （ 16 ）： e0254 .

FILIPPATOS G ， ANKER S D ， AGARWAL R ， et al . Finerenone reduces risk of incident heart failure in patients with chronic kidney disease and type 2 diabetes：analyses from the FIGARO-DKD trial [J ] . Circulation ， 2022 ， 145 （ 6 ）： 437 - 447 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Cost-utility analysis of dorzagliatin combined with metformin in the treatment of type 2 diabetes mellitus patients with poor glycemic control with metformin

Pharmacoeconomic evaluation of durvalumab combined with chemotherapy as first-line therapy for advanced biliary tract cancer

Cost-utility analysis of capecitabine metronomic chemotherapy combined with aromatase inhibitor as first-line treatment for HR+/HER2－ metastatic breast cancer

Cost-utility analysis of tislelizumab in the treatment of locally advanced or metastatic （non-）squamous NSCLC

Cost-utility analysis of ciclesonide and budesonide in the treatment of mild to moderate bronchial asthma

Related Author

GAO Ning

FENG Bing

GAO Shengnan

GUO Shan

NIU Mengna

LIU Guoqiang

HUO Liman

DUAN Yangyang

Related Institution

Hebei Society for Integrated Drug and Health Technology Assessment

Dept. of Clinical Pharmacy， Hebei Medical University Third Hospital

School of Health Emergency Management， Tianjin University

School of Pharmacy， Hebei Medical University

Dept. of Pharmacy， the Fourth Hospital of Hebei Medical University

Address：8th Floor, Sihuan Building, No. 129 Daping Main Street, Yuzhong District, Chongqing, China Postal code：400042
Technical support is provided by Beijing Founder Electronics co., LTD 渝ICP备15012710号公网安备50010302001817
It is recommended to read the content of this site in Chrome&IE9+. Please switch to extreme mode in browser 360.
Cookies We use cookies to help provide and enhance our service and tailor content. By continuing, you agree to the use of cookies.

⁰