Cost-effectiveness of B-type natriuretic peptide-guided care in patients with heart failure: a systematic review

Jafari, Abdosaleh; Rezapour, Aziz; Hajahmadi, Marjan

doi:10.1007/s10741-018-9710-3

Cited by 11 publications

(5 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HF is one of the leading causes of morbidity, mortality, and readmission to the hospital. The economic burden of the disease has increased dramatically over the past two decades, leading to the waste of resources and increases in the costs of health care systems [ 56 ]. In the last three decades, pharmaceutical treatments based on current clinical guidelines, including the use of Angiotensin Receptor Blockers, have shown significant success in reducing hospitalization, morbidity, and mortality associated with HF [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

Cost-utility analysis of valsartan, enalapril, and candesartan in patients with heart failure in Iran

Ravangard,

Jalali,

Hajahmadi

et al. 2023

Health Econ Rev

Self Cite

View full text Add to dashboard Cite

Background Today, heart failure is one of the leading causes of death and disability in most developed and developing countries. By 2030, more than 23.3 million people are projected to die of cardiovascular diseases each year, and the prevalence of heart failure is expected to increase by 25%. One of the preventive interventions is pharmacological interventions which can be used to reduce the complications of cardiovascular diseases such as heart failure. One of the most important pharmacological interventions in patients with heart failure is the use of antihypertensive drugs such as candesartan, enalapril, and valsartan. This study aimed to compare the cost-utility of candesartan, enalapril, and valsartan in patients with heart failure using the Markov model in Iran in 2020. Methods In the present study, a four-state Markov model was designed to compare the cost-utility of candesartan, enalapril, and valsartan for a hypothetical cohort of 10,000 heart failure patients older than 24 years. The payers’ perspective was used to calculate the costs. The Markov states included outpatients with heart failure, patients with heart failure admitted to general hospital wards, patients with heart failure admitted to the intensive care units (ICUs), and death. The effectiveness measure in this study was the quality-adjusted life years (QALYs). The one-way and probabilistic sensitivity analyses were used to determine the robustness of the results. The TreeAge Pro 2011 software was used for data analysis. Results The results showed that the average expected costs and QALYs were 119645.45 USD and 16.15 for valsartan, 113,019.68 USD and 15.16 for enalapril, and 113,093.37 USD and 15.06 for candesartan, respectively. Candesartan was recognized as the dominated option. Because the calculated incremental cost-effectiveness ratio (ICER) value (6,692.69 USD) was less than the threshold value (7,256 USD), valsartan was cost-effective compared to enalapril. The results of the cost-effectiveness acceptability curve showed that at the threshold of 7,256 USD, valsartan had a 60% chance of being cost-effective compared to enalapril. The results of one-way and probabilistic sensitivity analyses confirmed the robustness of the results. Moreover, the results showed that ICU (1,112 USD) had the highest cost among cost items. Conclusion According to the results, it is recommended that health policymakers consider the use of valsartan by cardiologists when designing clinical guidelines for the treatment of patients with heart failure.

show abstract

Section: Discussionmentioning

confidence: 99%

Cost-utility analysis of valsartan, enalapril, and candesartan in patients with heart failure in Iran

Ravangard,

Jalali,

Hajahmadi

et al. 2023

Health Econ Rev

Self Cite

View full text Add to dashboard Cite

show abstract

“…Final selected studies in this review reported a wide range of incremental costeffectiveness ratio (ICER). In order to compare different ICER, all of them were inflated by 2020 at an annual rate of 3% [19].…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of cardiac resynchronization therapy plus an implantable cardioverter-defibrillator in patients with heart failure: a systematic review

Teimourizad

Rezapour

Sadeghian

et al. 2021

Cost Eff Resour Alloc

Self Cite

View full text Add to dashboard Cite

Introduction Heart failure (HF) is an unusual heart function that causes reduction in cardiac or pulmonary output. Cardiac resynchronization therapy (CRT) is a mechanical device that helps to recover ventricular dysfunction by pacing the ventricles. This study planned to systematically review cost-effectiveness of CRT combined with an implantable cardioverter-defibrillator (ICD) versus ICD in patients with HF. Methods We used five databases (NHS Economic Evaluation Database, Cochrane Library, Medline, PubMed, and Scopus) to systematically reviewed studies published in the English language on the cost-effectiveness of CRT with defibrillator (CRT-D) Vs. ICD in patients with HF over 2000 to 2020. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist was applied to assess the quality of the selected studies. Results Five studies reporting the cost-effectiveness of CRT-D vs ICD were finally identified. The results revealed that time horizon, direct medical costs, type of model, discount rate, and sensitivity analysis obviously mentioned in almost all studies. All studies used quality-adjusted life years (QALYs) as an effectiveness measurement. The highest and the lowest Incremental cost-effectiveness ratio (ICER) were reported in the USA ($138,649per QALY) and the UK ($41,787per QALY), respectively. Conclusion Result of the study showed that CRT-D compared to ICD alone was the most cost-effective treatment in patients with HF.

show abstract

“…However, there is uncertainty about the cost effectiveness of BNP testing. A systematic review by Jafari et al (2018) concluded that the use of BNP testing in patients with heart failure may reduce cost compared to the symptom-based clinical care and increase QALY. Treatment of HF should not only take into account cost of treatment but also possible testing for markers such as BNP which may improve cost effectiveness of treatment.…”

Section: Gaps In Studies and Potential For Future Developmentmentioning

confidence: 99%

Cost effectiveness analyses of pharmacological treatments in heart failure

Lim¹,

Rahim

Zhao

et al. 2022

Front. Pharmacol.

View full text Add to dashboard Cite

In a rapidly growing and aging population, heart failure (HF) has become recognised as a public health concern that imposes high economic and societal costs worldwide. HF management stems from the use of highly cost-effective angiotensin converting enzyme inhibitors (ACEi) and β-blockers to the use of newer drugs such as sodium-glucose cotransporter-2 inhibitors (SGLT2i), ivabradine, and vericiguat. Modelling studies of pharmacological treatments that report on cost effectiveness in HF is important in order to guide clinical decision making. Multiple cost-effectiveness analysis of dapagliflozin for heart failure with reduced ejection fraction (HFrEF) suggests that it is not only cost-effective and has the potential to improve long-term clinical outcomes, but is also likely to meet conventional cost-effectiveness thresholds in many countries. Similar promising results have also been shown for vericiguat while a cost effectiveness analysis (CEA) of empagliflozin has shown cost effectiveness in HF patients with Type 2 diabetes. Despite the recent FDA approval of dapagliflozin and empagliflozin in HF, it might take time for these SGLT2i to be widely used in real-world practice. A recent economic evaluation of vericiguat found it to be cost effective at a higher cost per QALY threshold than SGLT2i. However, there is a lack of clinical or real-world data regarding whether vericiguat would be prescribed on top of newer treatments or in lieu of them. Sacubitril/valsartan has been commonly compared to enalapril in cost effectiveness analysis and has been found to be similar to that of SGLT2i but was not considered a cost-effective treatment for heart failure with reduced ejection fraction in Thailand and Singapore with the current economic evaluation evidences. In order for more precise analysis on cost effectiveness analysis, it is necessary to take into account the income level of various countries as it is certainly easier to allocate more financial resources for the intervention, with greater effectiveness, in high- and middle-income countries than in low-income countries. This review aims to evaluate evidence and cost effectiveness studies in more recent HF drugs i.e., SGLT2i, ARNi, ivabradine, vericiguat and omecamtiv, and gaps in current literature on pharmacoeconomic studies in HF.

show abstract

Cost-effectiveness of B-type natriuretic peptide-guided care in patients with heart failure: a systematic review

Cited by 11 publications

References 44 publications

Cost-utility analysis of valsartan, enalapril, and candesartan in patients with heart failure in Iran

Cost-utility analysis of valsartan, enalapril, and candesartan in patients with heart failure in Iran

Cost-effectiveness of cardiac resynchronization therapy plus an implantable cardioverter-defibrillator in patients with heart failure: a systematic review

Cost effectiveness analyses of pharmacological treatments in heart failure

Contact Info

Product

Resources

About