Related Experiment Video

Updated: Feb 17, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

11.1K

Cost-effectiveness of sacubitril/valsartan in chronic heart-failure patients with reduced ejection fraction

Zanfina Ademi1, Alena M Pfeil2, Elizabeth Hancock3

  • 1Institute of Pharmaceutical Medicine (ECPM), University of Basel, Switzerland, and Monash Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.

Swiss Medical Weekly
|November 30, 2017
PubMed

Insights

Sacubitril/valsartan is a cost-effective treatment for heart failure with reduced ejection fraction (HFrEF) compared to ACE inhibitors. This therapy reduces hospitalizations and improves survival, offering value within the Swiss healthcare system.

Area of Science:

  • Pharmacoeconomics
  • Cardiovascular Medicine
  • Health Technology Assessment

Background:

  • Chronic heart failure with reduced ejection fraction (HFrEF) poses a significant burden on healthcare systems.
  • Angiotensin-converting enzyme inhibitors (ACEIs) are a standard treatment, but novel therapies are being evaluated for improved outcomes and cost-effectiveness.
  • Assessing the economic value of new treatments is crucial for healthcare resource allocation.

Purpose of the Study:

  • To evaluate the cost-effectiveness of sacubitril/valsartan compared to ACEIs (specifically enalapril) for HFrEF patients in Switzerland.
  • To determine the incremental cost-effectiveness ratio (ICER) of sacubitril/valsartan from a healthcare system perspective.
  • To analyze the impact on hospitalizations, survival, and quality-adjusted life years (QALYs).

Main Methods:

  • A lifelong regression-based cohort model was developed, utilizing data from the PARADIGM-HF trial.
  • The model compared sacubitril/valsartan with enalapril for patients with HFrEF (NYHA Class II-IV).
  • Costs and QALYs were discounted at 3%, with sensitivity analyses performed to assess robustness.

Main Results:

  • Sacubitril/valsartan demonstrated a 6.0% absolute reduction in annual hospitalizations and an 8.0% decrease in lifetime hospital costs.
  • The treatment is predicted to increase overall survival by 0.50 years and QALYs by 0.42.
  • The base-case ICER was CHF 25,684 per QALY gained, with a 99.0% probability of cost-effectiveness at a threshold of CHF 50,000.

Conclusions:

  • Sacubitril/valsartan is a cost-effective treatment option for HFrEF patients in Switzerland when compared to enalapril.
  • The therapy provides significant clinical benefits, including reduced hospitalizations and improved survival, at an acceptable cost per QALY.
  • These findings support the adoption of sacubitril/valsartan within the Swiss healthcare system for eligible HFrEF patients.
Abstract

More Related Videos

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device07:41

Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device

Published on: July 20, 2022

2.4K
Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR07:24

Reduction in Left Ventricular Wall Stress and Improvement in Function in Failing Hearts using Algisyl-LVR

Published on: April 8, 2013

24.7K

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
374
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.2K
Heart Failure Drugs: Diuretics01:22

Heart Failure Drugs: Diuretics

Heart failure and kidney perfusion are interconnected in a complex way. Reduced renal perfusion and venous congestion are two significant factors that contribute to renal dysfunction in heart failure. The kidneys, primarily responsible for fluid balance in the body, are adversely affected due to compromised cardiac output and increased venous pressure. In response to reduced renal perfusion, the kidneys activate neurohumoral mechanisms to restore balance. However, these mechanisms can be...
1.0K
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
416
Heart Failure Drugs: β-Blockers01:22

Heart Failure Drugs: β-Blockers

β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
984
Heart Failure II: Pathophysiology01:29

Heart Failure II: Pathophysiology

Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1.0K