Cost-Effectiveness of Sacubitril-Valsartan vs Enalapril for Heart Failure With Reduced Ejection Fraction

HealthDay News – For patients with heart failure with reduced ejection fraction (HFrEF), sacubitril-valsartan may be cost-effective, depending on the willingness-to-pay threshold, according to a study published online March 30 in JACC: Heart Failure.

Jordan B. King, PharmD, from the University of Utah College of Pharmacy in Salt Lake City, and colleagues examined the cost-effectiveness of sacubitril-valsartan compared with enalapril for treatment of HFrEF. Costs, effects, and cost-effectiveness of the therapies were estimated using a Markov model. At model entry, patients were 60 years of age, and were modeled over 40 years from the perspective of a third-party payer.

Researchers found that over a lifetime, compared with enalapril, sacubitril-valsartan was more costly ($60 361 vs $21 758) and more effective (6.49 vs 5.74 quality-adjusted life-years [QALYs]) in the base case. The cost-effectiveness of sacubitril-valsartan varied with treatment duration, from $249 411 per QALY at 3 years to $50 959 per QALY gained over a lifetime.

“Sacubitril-valsartan may be a cost-effective treatment option depending on the willingness-to-pay threshold,” the authors wrote. “Future investigations should incorporate real-world evidence with sacubitril-valsartan to further inform decision making.”

Disclosures: Several authors disclosed financial ties to Amgen.


King JB, Shah RU, Bress AP, Nelson RE, Bellows BK. Cost-effectivness of sacubitril-valsartan combination therapy compared with enalapril for the treatment of heart failure with reduced ejection fraction. JACC Heart Fail. 2016. doi: 10.1016/j.chf.201.02.007.