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Cost-effectiveness of sacubitril/valsartan for the treatment of patients with heart failure with reduced ejection fraction in Portugal

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dc.contributor.authorBorges, Margarida
dc.contributor.authorAfonso Silva, Marta
dc.contributor.authorLaires, Pedro A.
dc.contributor.authorGouveia, Miguel
dc.contributor.authorAlarcão, Joana
dc.contributor.authorAscenção, Raquel
dc.contributor.authorCosta, João
dc.date.accessioned2019-06-24T15:57:43Z
dc.date.available2019-06-24T15:57:43Z
dc.date.issued2019
dc.description© 2019 Informa UK Limited, trading as Taylor & Francis Grouppt_PT
dc.description.abstractObjectives: This study assesses the cost-effectiveness of sacubitril/valsartan versus enalapril in patients with symptomatic heart failure with reduced ejection fraction (HFrEF). Methods: We used a previously developed Markov model calibrated with patient-level data from the PARADIGM-HF trial, adapted to the Portuguese setting. The model considers two health states (alive or dead) and uses regression analyzes to estimate hospitalizations and deaths over time. A panel of experts estimated resource consumption in the outpatient setting. To estimate resource consumption with hospitalizations, the National Health Service Diagnosis Related Groups database was used. Unit costs were based on national legislation, and on the Infomed database. The model considers a societal perspective, a time horizon of 30-years, and a 5% annual discount rate. Sensitivity analyses assessed the robustness of results. Results: Sacubitril/valsartan increases life expectancy by 0.5 life-years, corresponding to 0.4 incremental quality adjusted life-years (QALY) versus enalapril. The estimated incremental cost-effectiveness ratio (ICER) is 22,702€/QALY. Sensitivity analysis shows that results are robust, but sensitive to the parameter estimates of the cardiovascular survival curve. Conclusion: Sacubitril/valsartan is a cost-effective therapeutic option in the treatment of Portuguese patients with HFrEF and translate into significant health gains and increased life expectancy versus the current standard of care.pt_PT
dc.description.sponsorshipThis analysis was funded by Novartis Farma, Produtos Farmacêuticos SA.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationExpert Review of Pharmacoeconomics & Outcomes Researchpt_PT
dc.identifier.doi10.1080/14737167.2019.1628642pt_PT
dc.identifier.issn1473-7167
dc.identifier.urihttp://hdl.handle.net/10451/38772
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherTaylor & Francispt_PT
dc.relation.publisherversionhttps://www.tandfonline.com/toc/ierp20/currentpt_PT
dc.subjectHeart failurept_PT
dc.subjectCost-effectivenesspt_PT
dc.subjectAngiotensin-converting enzyme inhibitorspt_PT
dc.subjectAngiotensin receptor neprilysin inhibitorpt_PT
dc.subjectSacubitril/valsartanpt_PT
dc.titleCost-effectiveness of sacubitril/valsartan for the treatment of patients with heart failure with reduced ejection fraction in Portugalpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage7pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleExpert Review of Pharmacoeconomics and Outcomes Researchpt_PT
person.familyNameBorges
person.familyNameAscenção
person.familyNameCosta
person.givenNameMargarida
person.givenNameRaquel
person.givenNameJoão
person.identifier480560
person.identifier.ciencia-idDF15-F706-709E
person.identifier.orcid0000-0002-8563-6846
person.identifier.orcid0000-0002-9086-0973
person.identifier.orcid0000-0002-5831-4921
person.identifier.scopus-author-id7102828573
person.identifier.scopus-author-id55499748300
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationa414c62c-f8d0-447e-b0bc-779588853440
relation.isAuthorOfPublication1e50cf4b-b956-4f45-bcbc-e7c76396e6b6
relation.isAuthorOfPublication0924f405-2d3a-4914-9097-24aa639bd97f
relation.isAuthorOfPublication.latestForDiscoverya414c62c-f8d0-447e-b0bc-779588853440

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