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Entresto Cost-Effective, Could Postpone Over 28,000 Deaths Among HFrEF Patients
Two separate studies found that timely use of Entresto (sacubitril/valsartan) by eligible patients with heart failure could prevent or postpone more than 28,000 US deaths each year, as well as be cost-effective when compared with other high-value cardiovascular treatments.
Approximately 300,000 deaths in the US every year are contributed to heart failure, and roughly half of those individuals have heart failure with reduced ejection fraction (HFrEF). Entresto, a twice-daily medicine, is approved for the treatment of heart failure and was recently recommended over ACE inhibitors for the treatment of patients with heart failure in joint guidelines developed by the American College of Cardiology, the American Heart Association and the European Society of Cardiology. However, the drug is costly (about $4500 per year), raising concerns about whether it is worth prescribing the new drug to patients versus older, less expensive medicines.
The two new studies were both published in JAMA Cardiology. In one study, researchers obtained the population-based estimates of the number of patients with HFrEF from public sources. A multiple-way sensitivity analysis was performed to determine the potential numbers of prevented or postponed deaths after therapy. Of the 2,736,000 US patients with HFrEF, 2,287,296 (84%) were estimated to be candidates for Entresto therapy. The researchers determined that if all of these patients were prescribed Entresto, a total of 28,284 deaths per year would be prevented.
In the second study, researchers used data from the PARADIGM-HF trial to model the cost-effectiveness of Entresto over a 30-year time horizon in US adults (mean age, 63.8 years). Researchers calculated that use of Entresto instead of enalapril over 30 years would result in 220 fewer hospital admissions per 1000 patients with heart failure. Incremental costs and quality-adjusted-life-years (QALYS) gained with Entresto therapy were estimated to be $35,512 and 0.78, respectively. Sensitivity analyses demonstrated incremental cost-effectiveness ratios (ICERs) ranging from $35,357 to $75,301 per QALY for Entresto therapy, consistent with ICERs calculated for other high-value cardiovascular interventions.
Van Narasimhan, Global Head of Development and Chief Medical Officer of Novartis, stated in a press release, “Entresto has now independently received a class I recommendation in clinical guidelines and was shown in multiple analysis to be cost effective so physicians and health care systems should feel confident in ensuring rapid and broad use of this breakthrough medicine.”
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