Is Sacubitril-Valsartan Worth the Cost?

In an analysis of PARADIGM-HF data, the combination compares favorably with other cost-effectiveness estimates of implantable cardioverter-defibrillators.

In PARADIGM-HF (NEJM JW Cardiol Oct 2014 and N Engl J Med 2014; 371:993), combination sacubitril-valsartan significantly reduced risks for cardiovascular death and heart failure (HF) hospitalization compared with enalapril in selected patients with HF and reduced left-ventricular ejection fraction (HFrEF). The uptake of the combination in the U.S. has been slow, perhaps owing in part to cost (wholesale prices of about US$12.50/day for sacubitril-valsartan but pennies for generic angiotensin-converting enzyme [ACE] inhibitors). Now, researchers have compared the cost-effectiveness of sacubitril-valsartan with usual care (ACE inhibitor; alternatively, angiotensin-receptor blocker) in hypothetical patients with HFrEF and mean age 64.

In an anal…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)