Cost-Effectiveness of Sacubitril/Valsartan in Germany: An Application of the Efficiency Frontier.
Value Health
; 22(10): 1119-1127, 2019 10.
Article
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| MEDLINE
| ID: mdl-31563254
ABSTRACT
BACKGROUND:
To assess the cost-effectiveness of new treatments in Germany, the efficiency frontier (EF) method has been developed. We compared the cost-effectiveness analysis using international standards and the German methodology, using the heart failure drug sacubitril/valsartan as an example.METHODS:
A previously developed Markov model was adapted to include 4 treatment options no treatment, enalapril, candesartan, and sacubitril/valsartan. The internationally used incremental cost-effectiveness ratio (ICER) was calculated, as well as cost-effectiveness acceptability curves. Additionally, EFs, net monetary benefits (NMBs), and price-acceptability curves were created according to German guidelines. All analyses were performed from the perspective of the German Statutory Health Insurance.RESULTS:
The base-case ICER for sacubitril/valsartan compared to enalapril is 19 300/quality-adjusted life-year. On the cost-effectiveness acceptability curve, sacubitril/valsartan is most likely to be cost-effective, out of all included comparators, from a hypothetical willingness-to-pay threshold of 18 250/quality-adjusted life-year onward. No EF could be constructed for the base case. Taking the uncertainty of the input parameters into account for the probabilistic sensitivity analysis, a NMB of around -14 000 was calculated, depending on the outcome considered, with the NMB being zero at a daily price for sacubitril/valsartan ranging from 1.52 to 1.67.CONCLUSION:
We calculated an ICER for Germany, comparable to previously published cost-effectiveness analyses for Europe, which widely concluded sacubitril/valsartan to be cost-effective. Using the German EF approach, a considerable discount needs to be applied before sacubitril/valsartan can be considered cost-effective.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Tetrazoles
/
Análisis Costo-Beneficio
/
Antagonistas de Receptores de Angiotensina
/
Aminobutiratos
Tipo de estudio:
Guideline
/
Health_economic_evaluation
Aspecto:
Patient_preference
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Value Health
Asunto de la revista:
FARMACOLOGIA
Año:
2019
Tipo del documento:
Article