Cost‐Effectiveness of Ivabradine for Heart Failure in the United States
BackgroundIvabradine is a heart rate–lowering agent approved to reduce the risk of hospitalization for worsening heart failure. This study assessed the cost‐effectiveness of adding ivabradine to background therapy in the United States from the perspective of a commercial or Medicare Advantage payer....
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2016-05-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.003221 |
| _version_ | 1811334169742016512 |
|---|---|
| author | Anuraag R. Kansal Martin R. Cowie Adrian Kielhorn Stanimira Krotneva Ali Tafazzoli Ying Zheng Nicole Yurgin |
| author_facet | Anuraag R. Kansal Martin R. Cowie Adrian Kielhorn Stanimira Krotneva Ali Tafazzoli Ying Zheng Nicole Yurgin |
| author_sort | Anuraag R. Kansal |
| collection | DOAJ |
| description | BackgroundIvabradine is a heart rate–lowering agent approved to reduce the risk of hospitalization for worsening heart failure. This study assessed the cost‐effectiveness of adding ivabradine to background therapy in the United States from the perspective of a commercial or Medicare Advantage payer. Methods and ResultsA cost‐effectiveness, cohort‐based Markov model using a state transition approach tracked a cohort of heart failure patients with heart rate ≥70 beats per minute in sinus rhythm who were treated with ivabradine+background therapy or background therapy alone. Model inputs, including adjusted hazard ratios, rates of hospitalization and mortality, adverse events, and utility‐regression equations, were derived from a large US claims database and SHIFT (Systolic Heart failure treatment with the If inhibitor ivabradine Trial). In the commercial population, ivabradine+background therapy was associated with a cost savings of $8594 versus the cost of background therapy alone over a 10‐year time horizon, primarily because of reduced hospitalization. Ivabradine was associated with an incremental benefit of 0.24 quality‐adjusted life years over a 10‐year time horizon. In the Medicare Advantage population, the incremental cost‐effectiveness ratio for ivabradine was estimated to be $24 920/quality‐adjusted life years. ConclusionsThe cost‐effectiveness model suggests that for a commercial population, the addition of ivabradine to background therapy was associated with cost savings and improved clinical outcomes. For a Medicare Advantage population, the analysis indicates that the clinical benefit of ivabradine can be achieved at a reasonable cost. |
| first_indexed | 2024-04-13T17:03:51Z |
| format | Article |
| id | doaj.art-01eb19caad1a471da99eaa1040fdb3e7 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T17:03:51Z |
| publishDate | 2016-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-01eb19caad1a471da99eaa1040fdb3e72022-12-22T02:38:32ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802016-05-015510.1161/JAHA.116.003221Cost‐Effectiveness of Ivabradine for Heart Failure in the United StatesAnuraag R. Kansal0Martin R. Cowie1Adrian Kielhorn2Stanimira Krotneva3Ali Tafazzoli4Ying Zheng5Nicole Yurgin6Evidera, Bethesda, MDImperial College London, London, United KingdomAmgen Inc., Thousand Oaks, CAEvidera, Montreal, Quebec, CanadaEvidera, Bethesda, MDEvidera, Bethesda, MDAmgen Inc., Thousand Oaks, CABackgroundIvabradine is a heart rate–lowering agent approved to reduce the risk of hospitalization for worsening heart failure. This study assessed the cost‐effectiveness of adding ivabradine to background therapy in the United States from the perspective of a commercial or Medicare Advantage payer. Methods and ResultsA cost‐effectiveness, cohort‐based Markov model using a state transition approach tracked a cohort of heart failure patients with heart rate ≥70 beats per minute in sinus rhythm who were treated with ivabradine+background therapy or background therapy alone. Model inputs, including adjusted hazard ratios, rates of hospitalization and mortality, adverse events, and utility‐regression equations, were derived from a large US claims database and SHIFT (Systolic Heart failure treatment with the If inhibitor ivabradine Trial). In the commercial population, ivabradine+background therapy was associated with a cost savings of $8594 versus the cost of background therapy alone over a 10‐year time horizon, primarily because of reduced hospitalization. Ivabradine was associated with an incremental benefit of 0.24 quality‐adjusted life years over a 10‐year time horizon. In the Medicare Advantage population, the incremental cost‐effectiveness ratio for ivabradine was estimated to be $24 920/quality‐adjusted life years. ConclusionsThe cost‐effectiveness model suggests that for a commercial population, the addition of ivabradine to background therapy was associated with cost savings and improved clinical outcomes. For a Medicare Advantage population, the analysis indicates that the clinical benefit of ivabradine can be achieved at a reasonable cost.https://www.ahajournals.org/doi/10.1161/JAHA.116.003221cost‐effectivenessheart failureheart ratehospitalization |
| spellingShingle | Anuraag R. Kansal Martin R. Cowie Adrian Kielhorn Stanimira Krotneva Ali Tafazzoli Ying Zheng Nicole Yurgin Cost‐Effectiveness of Ivabradine for Heart Failure in the United States Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cost‐effectiveness heart failure heart rate hospitalization |
| title | Cost‐Effectiveness of Ivabradine for Heart Failure in the United States |
| title_full | Cost‐Effectiveness of Ivabradine for Heart Failure in the United States |
| title_fullStr | Cost‐Effectiveness of Ivabradine for Heart Failure in the United States |
| title_full_unstemmed | Cost‐Effectiveness of Ivabradine for Heart Failure in the United States |
| title_short | Cost‐Effectiveness of Ivabradine for Heart Failure in the United States |
| title_sort | cost effectiveness of ivabradine for heart failure in the united states |
| topic | cost‐effectiveness heart failure heart rate hospitalization |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.003221 |
| work_keys_str_mv | AT anuraagrkansal costeffectivenessofivabradineforheartfailureintheunitedstates AT martinrcowie costeffectivenessofivabradineforheartfailureintheunitedstates AT adriankielhorn costeffectivenessofivabradineforheartfailureintheunitedstates AT stanimirakrotneva costeffectivenessofivabradineforheartfailureintheunitedstates AT alitafazzoli costeffectivenessofivabradineforheartfailureintheunitedstates AT yingzheng costeffectivenessofivabradineforheartfailureintheunitedstates AT nicoleyurgin costeffectivenessofivabradineforheartfailureintheunitedstates |