Vericiguat versus sacubitril/valsartan for the treatment of heart failure with reduced ejection fraction in China: a cost-utility analysis.

IF 2.1 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Acta cardiologica Pub Date : 2025-05-01 Epub Date: 2025-03-31 DOI:10.1080/00015385.2025.2484848

Xingyuan Zhao, Nan Hu, Liying Wang, Zongling Xia

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引用次数: 0

Abstract

Background: PARADIGM-HF and VICTORIA studies have shown that treatment with sacubitril/valsartan or vericiguat could reduce cardiovascular mortality and hospitalisation in the patients with heart failure (HF) with reduced ejection fraction (HFrEF). However, the cost-utility analysis of adding sacubitril/valsartan or vericiguat to the standard treatment of heart failure in Chinese patients with HFrEF was still unclear.

Methods: Based on the Chinese healthcare system, a multi-state Markov model has been established for the cost-utility analysis and compared with the results of VICTORIA study subgroups and relevant local data in China. This model simulated the direct medical costs and quality-adjusted life years (QALYs) of HFrEF patients over a period of 20 years, in which these patients were treated with the standard treatment of heart failure and either adding sacubitril/valsartan or vericiguat. Moreover, incremental cost-utility ratio (ICUR) and incremental net monetary benefit (INMB) were also analysed and the robustness of the results was verified by using sensitivity analysis.

Results: In the base case study, according to the Chinese HFrEF patients, the total costs for the sacubitril/valsartan group and the vericiguat group were 4,237.42 USD and 4,618.59 USD, respectively, and the total utility was 3.62 and 3.48 QALYs, respectively. The ICUR was -2,611.68 USD/QALY, and the INMB was -5,772.32 USD. The sensitivity analysis indicated that the results were robust. The results of scenario analysis and base-case analysis were basically consistent.

Conclusions: On the standard treatment of heart failure, adding sacubitril/valsartan alone was more cost-effective than adding vericiguat alone for the treatment of HFrEF.

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Vericiguat与sacubitril/缬沙坦在中国治疗心力衰竭并降低射血分数：成本效用分析

背景：PARADIGM-HF和VICTORIA研究表明，使用苏比里尔/缬沙坦或vericiguat治疗心力衰竭（HF）伴射血分数降低（HFrEF）患者可降低心血管死亡率和住院率。然而，在中国HFrEF患者心力衰竭的标准治疗中加入苏比里尔/缬沙坦或维西格韦的成本-效用分析尚不清楚。方法：基于中国医疗卫生体系，建立多状态马尔可夫模型进行成本-效用分析，并与VICTORIA研究分组结果和中国相关地方数据进行比较。该模型模拟了HFrEF患者在20年期间的直接医疗费用和质量调整生命年（QALYs），其中这些患者接受心力衰竭的标准治疗，并添加苏比里尔/缬沙坦或vericiguat。此外，还分析了增量成本效用比（ICUR）和增量净货币效益（INMB），并利用敏感性分析验证了结果的稳健性。结果：在基础病例研究中，根据中国HFrEF患者，苏比里尔/缬沙坦组和vericiguat组的总成本分别为4237.42美元和4618.59美元，总效用分别为3.62和3.48 QALYs。ICUR为- 2611.68美元/QALY， INMB为- 577.2.32美元/QALY。敏感性分析表明，结果是稳健的。情景分析和基本案例分析的结果基本一致。结论：在心力衰竭的标准治疗中，单独加用苏比里尔/缬沙坦治疗HFrEF比单独加用vericiguat更具成本效益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta cardiologica 医学-心血管系统

CiteScore

2.50

自引率

12.50%

发文量

115

审稿时长

2 months

期刊介绍： Acta Cardiologica is an international journal. It publishes bi-monthly original, peer-reviewed articles on all aspects of cardiovascular disease including observational studies, clinical trials, experimental investigations with clear clinical relevance and tutorials.