Cost-Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines
Abstract Objectives To describe the adaptation of a global health economic model to determine whether treatment with the angiotensin receptor neprilysin inhibitor LCZ696 is cost-effective compared with the angiotensin-converting enzyme inhibitor enalapril in adult patients with chronic heart failure...
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| Veröffentlicht in: | Value in health 2017-12, Vol.20 (10), p.1260-1269 |
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| creator | Ramos, Isaac Corro, PhD Versteegh, Matthijs M., PhD de Boer, Rudolf A., MD, PhD Koenders, Jolanda M.A., MSc Linssen, Gerard C.M., MD, PhD Meeder, Joan G., MD, PhD Rutten-van Mölken, Maureen P.M.H., PhD |
| description | Abstract Objectives To describe the adaptation of a global health economic model to determine whether treatment with the angiotensin receptor neprilysin inhibitor LCZ696 is cost-effective compared with the angiotensin-converting enzyme inhibitor enalapril in adult patients with chronic heart failure with reduced left ventricular ejection fraction in the Netherlands; and to explore the effect of performing the cost-effectiveness analyses according to the new pharmacoeconomic Dutch guidelines (updated during the submission process of LCZ696), which require a value-of-information analysis and the inclusion of indirect medical costs of life-years gained. Methods We adapted a UK model to reflect the societal perspective in the Netherlands by including travel expenses, productivity loss, informal care costs, and indirect medical costs during the life-years gained and performed a preliminary value-of-information analysis. Results The incremental cost-effectiveness ratio obtained was €17,600 per quality-adjusted life-year (QALY) gained. This was robust to changes in most structural assumptions and across different subgroups of patients. Probability sensitivity analysis results showed that the probability that LCZ696 is cost-effective at a €50,000 per QALY threshold is 99.8%, with a population expected value of perfect information of €297,128. On including indirect medical costs of life-years gained, the incremental cost-effectiveness ratio was €26,491 per QALY gained, and LCZ696 was 99.46% cost-effective at €50,000 per QALY, with a population expected value of perfect information of €2,849,647. Conclusions LCZ696 is cost-effective compared with enalapril under the former and current Dutch guidelines. However, the (monetary) consequences of making a wrong decision were considerably different in both scenarios. |
| doi_str_mv | 10.1016/j.jval.2017.05.013 |
| format | Article |
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Methods We adapted a UK model to reflect the societal perspective in the Netherlands by including travel expenses, productivity loss, informal care costs, and indirect medical costs during the life-years gained and performed a preliminary value-of-information analysis. Results The incremental cost-effectiveness ratio obtained was €17,600 per quality-adjusted life-year (QALY) gained. This was robust to changes in most structural assumptions and across different subgroups of patients. Probability sensitivity analysis results showed that the probability that LCZ696 is cost-effective at a €50,000 per QALY threshold is 99.8%, with a population expected value of perfect information of €297,128. On including indirect medical costs of life-years gained, the incremental cost-effectiveness ratio was €26,491 per QALY gained, and LCZ696 was 99.46% cost-effective at €50,000 per QALY, with a population expected value of perfect information of €2,849,647. Conclusions LCZ696 is cost-effective compared with enalapril under the former and current Dutch guidelines. However, the (monetary) consequences of making a wrong decision were considerably different in both scenarios.</description><identifier>ISSN: 1098-3015</identifier><identifier>EISSN: 1524-4733</identifier><identifier>DOI: 10.1016/j.jval.2017.05.013</identifier><identifier>PMID: 29241885</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>ACE inhibitor ; ACE inhibitors ; Adaptation ; Aged ; Aminobutyrates - economics ; Aminobutyrates - therapeutic use ; Analysis ; Angiotensin Receptor Antagonists - economics ; Angiotensin Receptor Antagonists - therapeutic use ; Angiotensin-converting enzyme inhibitors ; Angiotensin-Converting Enzyme Inhibitors - economics ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Chronic Disease ; Cost analysis ; Cost-Benefit Analysis ; cost-effectiveness analysis ; Decision making ; Drug Combinations ; Economic models ; Economics ; Economics, Pharmaceutical ; Enalapril - economics ; Enalapril - therapeutic use ; Enzyme inhibitors ; Female ; Global health ; Guidelines as Topic ; Health care expenditures ; Heart diseases ; Heart failure ; Heart Failure - drug therapy ; Heart Failure - economics ; Humans ; Indirect costs ; Informal care ; Internal Medicine ; Male ; Middle Aged ; Models, Economic ; Neprilysin ; Neprilysin - antagonists & inhibitors ; Netherlands ; Patients ; Peptidyl-dipeptidase A ; Pharmacoeconomics ; Pharmacology ; Productivity ; productivity costs ; Quality adjusted life years ; Quality of life ; Randomized Controlled Trials as Topic ; Sensitivity analysis ; Stroke Volume - drug effects ; Tetrazoles - economics ; Tetrazoles - therapeutic use ; Ventricle</subject><ispartof>Value in health, 2017-12, Vol.20 (10), p.1260-1269</ispartof><rights>International Society for Pharmacoeconomics and Outcomes Research (ISPOR)</rights><rights>2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR)</rights><rights>Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Dec 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-d0056691a65ca45a149d8b26ce1fce57fd6222394c150af9f9e2eb30607fc6583</citedby><cites>FETCH-LOGICAL-c483t-d0056691a65ca45a149d8b26ce1fce57fd6222394c150af9f9e2eb30607fc6583</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1098301517302619$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,30976,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29241885$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ramos, Isaac Corro, PhD</creatorcontrib><creatorcontrib>Versteegh, Matthijs M., PhD</creatorcontrib><creatorcontrib>de Boer, Rudolf A., MD, PhD</creatorcontrib><creatorcontrib>Koenders, Jolanda M.A., MSc</creatorcontrib><creatorcontrib>Linssen, Gerard C.M., MD, PhD</creatorcontrib><creatorcontrib>Meeder, Joan G., MD, PhD</creatorcontrib><creatorcontrib>Rutten-van Mölken, Maureen P.M.H., PhD</creatorcontrib><title>Cost-Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines</title><title>Value in health</title><addtitle>Value Health</addtitle><description>Abstract Objectives To describe the adaptation of a global health economic model to determine whether treatment with the angiotensin receptor neprilysin inhibitor LCZ696 is cost-effective compared with the angiotensin-converting enzyme inhibitor enalapril in adult patients with chronic heart failure with reduced left ventricular ejection fraction in the Netherlands; and to explore the effect of performing the cost-effectiveness analyses according to the new pharmacoeconomic Dutch guidelines (updated during the submission process of LCZ696), which require a value-of-information analysis and the inclusion of indirect medical costs of life-years gained. Methods We adapted a UK model to reflect the societal perspective in the Netherlands by including travel expenses, productivity loss, informal care costs, and indirect medical costs during the life-years gained and performed a preliminary value-of-information analysis. Results The incremental cost-effectiveness ratio obtained was €17,600 per quality-adjusted life-year (QALY) gained. This was robust to changes in most structural assumptions and across different subgroups of patients. Probability sensitivity analysis results showed that the probability that LCZ696 is cost-effective at a €50,000 per QALY threshold is 99.8%, with a population expected value of perfect information of €297,128. On including indirect medical costs of life-years gained, the incremental cost-effectiveness ratio was €26,491 per QALY gained, and LCZ696 was 99.46% cost-effective at €50,000 per QALY, with a population expected value of perfect information of €2,849,647. Conclusions LCZ696 is cost-effective compared with enalapril under the former and current Dutch guidelines. However, the (monetary) consequences of making a wrong decision were considerably different in both scenarios.</description><subject>ACE inhibitor</subject><subject>ACE inhibitors</subject><subject>Adaptation</subject><subject>Aged</subject><subject>Aminobutyrates - economics</subject><subject>Aminobutyrates - therapeutic use</subject><subject>Analysis</subject><subject>Angiotensin Receptor Antagonists - economics</subject><subject>Angiotensin Receptor Antagonists - therapeutic use</subject><subject>Angiotensin-converting enzyme inhibitors</subject><subject>Angiotensin-Converting Enzyme Inhibitors - economics</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Chronic Disease</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>cost-effectiveness analysis</subject><subject>Decision making</subject><subject>Drug Combinations</subject><subject>Economic models</subject><subject>Economics</subject><subject>Economics, Pharmaceutical</subject><subject>Enalapril - economics</subject><subject>Enalapril - therapeutic use</subject><subject>Enzyme inhibitors</subject><subject>Female</subject><subject>Global health</subject><subject>Guidelines as Topic</subject><subject>Health care expenditures</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - economics</subject><subject>Humans</subject><subject>Indirect costs</subject><subject>Informal care</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Models, Economic</subject><subject>Neprilysin</subject><subject>Neprilysin - antagonists & inhibitors</subject><subject>Netherlands</subject><subject>Patients</subject><subject>Peptidyl-dipeptidase A</subject><subject>Pharmacoeconomics</subject><subject>Pharmacology</subject><subject>Productivity</subject><subject>productivity costs</subject><subject>Quality adjusted life years</subject><subject>Quality of life</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Sensitivity analysis</subject><subject>Stroke Volume - drug effects</subject><subject>Tetrazoles - economics</subject><subject>Tetrazoles - therapeutic use</subject><subject>Ventricle</subject><issn>1098-3015</issn><issn>1524-4733</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp9Uk1v1DAQDQhES0HcOSBLXLhkaztxPhBCWoXdtlJVKkq5Wl5nwnpJ7MV2Fu2_Z9ItPfSAD_bIfjPznuclyVtGZ4yy4nQz2-xUP-OUlTMqZpRlT5NjJnie5mWWPcOY1lWaUSaOkpchbCilRcbFi-SI1zxnVSWOn7xpXIjpoutAR7MDCyEQ15G4BjK3P42LYIOx5Bto2EbnyRVsven3092FXZuVmS5vlB4xwofTH6oPykdlSYcP1yoasDGQPyauSbP2zhpNzgERZKlMP3ogyrZYvh01tGSxmWg4S5ZeHQLsM3G5Atx9j9jwkcxJ40Yb_Z7MW7WN6g44t2qiFcitbcHfJS2dHzCcGjSj90iEfBmjXpPrtfKD0g60s25ARmejaaE3qP5V8rxDCfD6_jxJbpeL7815evn17KKZX6Y6r7KYtpSKoqiZKoRWuVAsr9tqxQsNrNMgyq4tOOdZnWsmqOrqrgYOq4wWtOx0IarsJPlwqLv17vcIIcrBBA09SgQ3BsnqEldd0hKh7x9BN270KDdITqs8FzSra0TxA0p7F4KHTuKgBuX3klE52UVu5GQXOdlFUiHRLpj07r70uBqgfUj55w8EfDoAAP9iZ8DLoHGiOCvjcVSydeb_9T8_Stf4y0ar_hfsITzoYDJwSeXNZNjJr6zMKC9Ynf0FB_HrEg</recordid><startdate>20171201</startdate><enddate>20171201</enddate><creator>Ramos, Isaac Corro, PhD</creator><creator>Versteegh, Matthijs M., PhD</creator><creator>de Boer, Rudolf A., MD, PhD</creator><creator>Koenders, Jolanda M.A., MSc</creator><creator>Linssen, Gerard C.M., MD, PhD</creator><creator>Meeder, Joan G., MD, PhD</creator><creator>Rutten-van Mölken, Maureen P.M.H., PhD</creator><general>Elsevier Inc</general><general>Elsevier Science Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7X8</scope></search><sort><creationdate>20171201</creationdate><title>Cost-Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines</title><author>Ramos, Isaac Corro, PhD ; Versteegh, Matthijs M., PhD ; de Boer, Rudolf A., MD, PhD ; Koenders, Jolanda M.A., MSc ; Linssen, Gerard C.M., MD, PhD ; Meeder, Joan G., MD, PhD ; Rutten-van Mölken, Maureen P.M.H., PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-d0056691a65ca45a149d8b26ce1fce57fd6222394c150af9f9e2eb30607fc6583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>ACE inhibitor</topic><topic>ACE inhibitors</topic><topic>Adaptation</topic><topic>Aged</topic><topic>Aminobutyrates - economics</topic><topic>Aminobutyrates - therapeutic use</topic><topic>Analysis</topic><topic>Angiotensin Receptor Antagonists - economics</topic><topic>Angiotensin Receptor Antagonists - therapeutic use</topic><topic>Angiotensin-converting enzyme inhibitors</topic><topic>Angiotensin-Converting Enzyme Inhibitors - economics</topic><topic>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</topic><topic>Chronic Disease</topic><topic>Cost analysis</topic><topic>Cost-Benefit Analysis</topic><topic>cost-effectiveness analysis</topic><topic>Decision making</topic><topic>Drug Combinations</topic><topic>Economic models</topic><topic>Economics</topic><topic>Economics, Pharmaceutical</topic><topic>Enalapril - economics</topic><topic>Enalapril - therapeutic use</topic><topic>Enzyme inhibitors</topic><topic>Female</topic><topic>Global health</topic><topic>Guidelines as Topic</topic><topic>Health care expenditures</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - economics</topic><topic>Humans</topic><topic>Indirect costs</topic><topic>Informal care</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Models, Economic</topic><topic>Neprilysin</topic><topic>Neprilysin - antagonists & inhibitors</topic><topic>Netherlands</topic><topic>Patients</topic><topic>Peptidyl-dipeptidase A</topic><topic>Pharmacoeconomics</topic><topic>Pharmacology</topic><topic>Productivity</topic><topic>productivity costs</topic><topic>Quality adjusted life years</topic><topic>Quality of life</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Sensitivity analysis</topic><topic>Stroke Volume - drug effects</topic><topic>Tetrazoles - economics</topic><topic>Tetrazoles - therapeutic use</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ramos, Isaac Corro, PhD</creatorcontrib><creatorcontrib>Versteegh, Matthijs M., PhD</creatorcontrib><creatorcontrib>de Boer, Rudolf A., MD, PhD</creatorcontrib><creatorcontrib>Koenders, Jolanda M.A., MSc</creatorcontrib><creatorcontrib>Linssen, Gerard C.M., MD, PhD</creatorcontrib><creatorcontrib>Meeder, Joan G., MD, PhD</creatorcontrib><creatorcontrib>Rutten-van Mölken, Maureen P.M.H., PhD</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>MEDLINE - Academic</collection><jtitle>Value in health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ramos, Isaac Corro, PhD</au><au>Versteegh, Matthijs M., PhD</au><au>de Boer, Rudolf A., MD, PhD</au><au>Koenders, Jolanda M.A., MSc</au><au>Linssen, Gerard C.M., MD, PhD</au><au>Meeder, Joan G., MD, PhD</au><au>Rutten-van Mölken, Maureen P.M.H., PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines</atitle><jtitle>Value in health</jtitle><addtitle>Value Health</addtitle><date>2017-12-01</date><risdate>2017</risdate><volume>20</volume><issue>10</issue><spage>1260</spage><epage>1269</epage><pages>1260-1269</pages><issn>1098-3015</issn><eissn>1524-4733</eissn><abstract>Abstract Objectives To describe the adaptation of a global health economic model to determine whether treatment with the angiotensin receptor neprilysin inhibitor LCZ696 is cost-effective compared with the angiotensin-converting enzyme inhibitor enalapril in adult patients with chronic heart failure with reduced left ventricular ejection fraction in the Netherlands; and to explore the effect of performing the cost-effectiveness analyses according to the new pharmacoeconomic Dutch guidelines (updated during the submission process of LCZ696), which require a value-of-information analysis and the inclusion of indirect medical costs of life-years gained. Methods We adapted a UK model to reflect the societal perspective in the Netherlands by including travel expenses, productivity loss, informal care costs, and indirect medical costs during the life-years gained and performed a preliminary value-of-information analysis. Results The incremental cost-effectiveness ratio obtained was €17,600 per quality-adjusted life-year (QALY) gained. This was robust to changes in most structural assumptions and across different subgroups of patients. Probability sensitivity analysis results showed that the probability that LCZ696 is cost-effective at a €50,000 per QALY threshold is 99.8%, with a population expected value of perfect information of €297,128. On including indirect medical costs of life-years gained, the incremental cost-effectiveness ratio was €26,491 per QALY gained, and LCZ696 was 99.46% cost-effective at €50,000 per QALY, with a population expected value of perfect information of €2,849,647. Conclusions LCZ696 is cost-effective compared with enalapril under the former and current Dutch guidelines. However, the (monetary) consequences of making a wrong decision were considerably different in both scenarios.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29241885</pmid><doi>10.1016/j.jval.2017.05.013</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); MEDLINE; Elsevier ScienceDirect Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | ACE inhibitor ACE inhibitors Adaptation Aged Aminobutyrates - economics Aminobutyrates - therapeutic use Analysis Angiotensin Receptor Antagonists - economics Angiotensin Receptor Antagonists - therapeutic use Angiotensin-converting enzyme inhibitors Angiotensin-Converting Enzyme Inhibitors - economics Angiotensin-Converting Enzyme Inhibitors - therapeutic use Chronic Disease Cost analysis Cost-Benefit Analysis cost-effectiveness analysis Decision making Drug Combinations Economic models Economics Economics, Pharmaceutical Enalapril - economics Enalapril - therapeutic use Enzyme inhibitors Female Global health Guidelines as Topic Health care expenditures Heart diseases Heart failure Heart Failure - drug therapy Heart Failure - economics Humans Indirect costs Informal care Internal Medicine Male Middle Aged Models, Economic Neprilysin Neprilysin - antagonists & inhibitors Netherlands Patients Peptidyl-dipeptidase A Pharmacoeconomics Pharmacology Productivity productivity costs Quality adjusted life years Quality of life Randomized Controlled Trials as Topic Sensitivity analysis Stroke Volume - drug effects Tetrazoles - economics Tetrazoles - therapeutic use Ventricle |
| title | Cost-Effectiveness of the Angiotensin Receptor Neprilysin Inhibitor Sacubitril/Valsartan for Patients with Chronic Heart Failure and Reduced Ejection Fraction in the Netherlands: A Country Adaptation Analysis Under the Former and Current Dutch Pharmacoeconomic Guidelines |
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