Cost-Effectiveness of Sacubitril-Valsartan Compared to Angiotensin-Converting Enzyme Inhibitors in Patients With Heart Failure With Reduced Ejection Fraction

J Pharm Pract. 2023 Aug;36(4):915-924. doi: 10.1177/08971900221087106. Epub 2022 Apr 13.

Abstract

Objectives: The goal of this study was to compare cost-effectiveness of sacubitril/valsartan with angiotensin-converting enzyme (ACE) inhibitors for treating chronic heart failure patients with reduced ejection fraction (HFrEF) from the published articles and explore the methodology applied in the studies. Methods: Systematic research was conducted in February 2021 using PubMed, Cochrane, and EBSCO. A combination of MeSH terms of "cost-effectiveness analysis," "heart failure with reduced ejection fraction," "sacubitril valsartan," and "angiotensin converting enzyme inhibitor" was employed. The review selected for articles published in the last five years in English. Results: A total of 15 studies were included in this review. We found that these studies had been conducted in 12 different countries. The United States had the greatest number of publications (5), followed by the Netherlands (2). The study method most used was the Markov decision model (73%). Almost all studies produced ICERs and QALYs that were numerically high. Conclusions: The use of sacubitril/valsartan associates with longer life expectancy and incremental cost-effectiveness ratio than angiotensin-converting enzyme inhibitors.

Keywords: angiotensin-converting enzyme inhibitors; cost-effectiveness; heart failure with reduced ejection fraction; sacubitril; valsartan.

Publication types

  • Review

MeSH terms

  • Aminobutyrates / therapeutic use
  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Cost-Benefit Analysis
  • Drug Combinations
  • Heart Failure* / drug therapy
  • Humans
  • Stroke Volume
  • Tetrazoles / therapeutic use
  • United States
  • Valsartan

Substances

  • sacubitril and valsartan sodium hydrate drug combination
  • Angiotensin-Converting Enzyme Inhibitors
  • sacubitril
  • Tetrazoles
  • Angiotensin Receptor Antagonists
  • Valsartan
  • Aminobutyrates
  • Drug Combinations