Cost-Effectiveness of Sacubitril–Valsartan in Patients Who Have Heart Failure With Reduced Ejection Fraction
Authors: Alexander T. Sandhu, Daniel A. Ollendorf, Richard H. Chapman, Steven D. Pearson, Paul A. Heidenreich
Journal: Annals of Internal Medicine (2017)

Letters18 April 2017Cost-Effectiveness of Sacubitril–Valsartan in Patients Who Have Heart Failure With Reduced Ejection FractionAlexander T. Sandhu, MD, MS, Daniel A. Ollendorf, PhD, Richard H. Chapman, PhD, Steven D. Pearson, MD, MSc, and Paul A. Heidenreich, MD, MSAlexander T. Sandhu, MD, MSFrom Stanford University, Stanford, California; Institute for Clinical and Economic Review, Boston, Massachusetts; Veterans Affairs Palo Alto Health Care System, Palo Alto, California., Daniel A. Ollendorf, PhDFrom Stanford University, Stanford, California; Institute for Clinical and Economic Review, Boston, Massachusetts; Veterans Affairs Palo Alto Health Care System, Palo Alto, California., Richard H. Chapman, PhDFrom Stanford University, Stanford, California; Institute for Clinical and Economic Review, Boston, Massachusetts; Veterans Affairs Palo Alto Health Care System, Palo Alto, California., Steven D. Pearson, MD, MScFrom Stanford University, Stanford, California; Institute for Clinical and Economic Review, Boston, Massachusetts; Veterans Affairs Palo Alto Health Care System, Palo Alto, California., and Paul A. Heidenreich, MD, MSFrom Stanford University, Stanford, California; Institute for Clinical and Economic Review, Boston, Massachusetts; Veterans Affairs Palo Alto Health Care System, Palo Alto, California.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0044 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. King and colleagues about the importance of the multiple cost-effectiveness analyses of sacubitril–valsartan that have been published (1, 2). The consistency in these findings supports the internal validity of these models that were designed using the PARADIGM-HF trial results (3) but does not strengthen the external validity of these results or the likelihood that these estimates will match real-world cost-effectiveness. Given that this combination therapy is novel, data are not sufficient to estimate real-world effectiveness or indication drift. However, we believe that estimating the value of a treatment early in the adoption process is ...References1. King JB, Shah RU, Bress AP, Nelson RE, Bellows BK. Cost-effectiveness of sacubitril-valsartan combination therapy compared with enalapril for the treatment of heart failure with reduced ejection fraction. JACC Heart Fail. 2016;4:392-402. [PMID: 27039128] doi:10.1016/j.jchf.2016.02.007 CrossrefMedlineGoogle Scholar2. Gaziano TA, Fonarow GC, Claggett B, Chan WW, Deschaseaux-Voinet C, Turner SJ, et al. Cost-effectiveness analysis of sacubitril/valsartan vs enalapril in patients with heart failure and reduced ejection fraction. JAMA Cardiol. 2016;1:666-72. [PMID: 27438344] doi:10.1001/jamacardio.2016.1747 CrossrefMedlineGoogle Scholar3. McMurray JJ, Packer M, Desai AS, Gong J, Lefkowitz MP, Rizkala AR, et al; PARADIGM-HF Investigators and Committees. Angiotensin–neprilysin inhibition versus enalapril in heart failure. N Engl J Med. 2014;371:993-1004. [PMID: 25176015] doi:10.1056/NEJMoa1409077 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Stanford University, Stanford, California; Institute for Clinical and Economic Review, Boston, Massachusetts; Veterans Affairs Palo Alto Health Care System, Palo Alto, California.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0057. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Sacubitril–Valsartan in Patients With Heart Failure With Reduced Ejection Fraction Alexander T. Sandhu , Daniel A. Ollendorf , Richard H. Chapman , Steven D. Pearson , and Paul A. Heidenreich Cost-Effectiveness of Sacubitril–Valsartan in Patients Who Have Heart Failure With Reduced Ejection Fraction Jordan King , Adam Bress , and Brandon Bellows Metrics Cited byAlert-driven vs scheduled remote monitoring of implantable cardiac defibrillators: A cost–consequence analysis from the TRUST trialClinical and Economic Outcomes Associated With Remote Monitoring for Cardiac Implantable Electronic Devices: A Population-Based AnalysisCost-effectiveness of Dapagliflozin for Treatment of Patients With Heart Failure With Reduced Ejection FractionRationale for and Practical Use of Sacubitril/Valsartan in the Patient's Journey with Heart Failure and Reduced Ejection FractionEconomic Evaluation of Catheter Ablation of Atrial Fibrillation in Patients with Heart Failure With Reduced Ejection Fraction 18 April 2017Volume 166, Issue 8Page: 607-608KeywordsDisclosureEjection fractionHeart failure ePublished: 18 April 2017 Issue Published: 18 April 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...