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Comparative pharmacoeconomic analysis of medication for patients after acute decompensated heart failure

https://doi.org/10.15829/1560-4071-2020-1-3690

Abstract

Aim. Pharmacoeconomic comparison of medication management strategies (valsartan+ sacubitril) for patients with heart failure (HF), stabilized after an episode of acute decompensated heart failure (ADHF).

Material and methods. “Cost — effectiveness analysis” and “Budget impact analysis” were used. The study is conducted in terms of the interests of Russian Federation health care system and budgets of individual regions.

Results. The use of valsartan+sacubitril combination will require an increase in direct medical costs for 1 year by 38,5% compared with enalapril. The cost of one life year gained when using the valsartan+sacubitril combination was 307,294 rubles. When estimating data for the target ADHF population (n=200,769), valsartan+sacubitril will require additional 4,4 billion rubles per year. At the same time, this will save almost 17 thousand lives and prevent 126 thousand ambulance calls and 33,9 thousand rehospitalizations, including more than 6,5 thousand in the intensive care unit.

Conclusion. The use of valsartan+sacubitril combination in HF patients hospitalized with ADHF is cost-effective management strategy that significantly improves the prognosis in this category of patients.

About the Authors

S. K. Zyryanov
Peoples’ Friendship University of Russia
Russian Federation
Moscow
Competing Interests: Автор заявляет о наличии потенциального конфликта интересов. 


E. A. Ushkalova
Peoples’ Friendship University of Russia
Moscow
Competing Interests: Автор заявляет о наличии потенциального конфликта интересов. 


References

1. Ambrosy AP, Fonarow GC, Butler J, et al. The Global Health and Economic Burden of Hospitalizations for Heart Failure: Lessons Learned From Hospitalized Heart Failure Registries. Journal of the American College of Cardiology. 2014;63(12):1123-33. doi:10.1016/j.jacc.2013.11.053.

2. Mareev VYu, Fomin IV, Ageev FT, et al. Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment. Kardiologiia, 2018;58(S6):5-151. (In Russ.) doi:10.18087/cardio.2475.

3. Mareev VYu, Ageev FT, Arutyunov GP, et al. Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine National guidelines for diagnostic and treatment of heart failure (4-th revision). Russian Heart Failure Journal. 2013;81(7):379-472. (In Russ.)

4. McMurray JJV, Packer M, Desai AS, et al., PARADIGM-HF Committees and Investigators. Dual angiotensin receptor and neprilysin inhibition as an alternative to angiotensinconverting enzyme inhibition in patients with chronic systolic heart failure: rationale for and design of the Prospective comparison of ARNI with ACEI to Determine Impact on Global Mortality and morbidity in Heart Failure trial (PARADIGM-HF). European Journal of Heart Failure. 2013;15(9):1062-73. doi:10.1093/eurjhf/hft052.

5. Order of the Government of the Russian Federation No. 2323-R of October 23, 2017. (In Russ.) https://rg.ru/2017/10/25/pravitelstvo-rasp2323-site-dok.html (14.10.2019).

6. Velazquez EJ, Morrow DA, DeVore AD, et al. PIONEER-HF Investigators AngiotensinNeprilysin Inhibition in Acute Decompensated Heart Failure. The New England Journal of Medicine. 2019;380(6):539-48. doi:10.1056/NEJMoa1812851.

7. Echouffo-Tcheugui JB, Bishu KG, Fonarow GC, et al. Trends in Health Care Expenditure among U.S. Adults with Heart Failure — The Medical Expenditure Panel Survey 2002-2011. American heart journal. 2017;186:63-72. doi:10.1016/j.ahj.2017.01.003.

8. Zhuravleva MV, Kukes VG, Prokof’ev AB, et al. Clinical and economic analysis of the use of innovative drug sacubitril/valsartan in the treatment of patients suffering from chronic heart failure with reduced ejection fraction. RMJ. 2017;4:282-9. (In Russ.)

9. Omelyanovsky VV, Avksentyeva MV, Sura MV, et al. Methodical guidelines on calculation of expenses for clinical economical studies of medicines. Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation. 2017. (In Russ.)

10. Omelyanovsky VV, Avksentyeva MV, Sura MV, et al. Methodical guidelines on comparative clinical economical estimation of medicine. Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation. 2018. (In Russ.) https://rosmedex.ru/wp-content/uploads/2019/06/MR-KE%60I_novaya-redaktsiya_2018-g..pdf

11. Omelyanovsky VV, Avksentyeva MV, Sura MV, Khachatryan GR. Methodical guidelines on estimation of budget impact in frame of implementation of programs of governmental guarantees of free medical care to citizens. Center for Healthcare Quality Assessment and Control of the Ministry of Health of the Russian Federation, 2018. (In Russ.)

12. Zyryanov SK, Cheberda AE, Belousov DY. Pharmacoeconomic Analysis of Chronic Heart Failure Drug Therapy in Patients with Comorbid Conditions. Rational Pharmacotherapy in Cardiology. 2018;14(2):167-75. (In Russ.) doi:10.20996/1819-6446-2018-14-2-167-175.

13. Seferovic JP, Claggett B, Seidelmann SB, et al. Effect of sacubitril/valsartan versus enalapril on glycaemic control in patients with heart failure and diabetes: a post-hoc analysis from the PARADIGM-HF trial. The Lancet. Diabetes & Endocrinology. 2017;5:33340. doi:10.1016/S2213-8587(17)30087-6.

14. Tariff agreement for payment of medical care provided under the territorial program of compulsory medical insurance of the city of Moscow for 2019. Mgfoms, 2019. (In Russ.)

15. State register of medicines. (In Russ.) http://grls.rosminzdrav.ru/Default.aspx (08.11.2019).

16. Belousov DU, Afansyeva EV. Basal insulin analogues in the diabetes mellitus type 2 control — economic aspects. Kačestvennaa kliničeskaa praktika. 2014;1:3-13. (In Russ.)

17. Arutyunov AG, Dragunov DO, Arutyunov GP, et al. First Open Study of Syndrome of Acute Decompensation of Heart Failure and Concomitant Diseases in Russian Federation: Independent Registry ORAKUL. Kardiologiia. 2015;55(5):12-21. (In Russ.)

18. Berdnikov SV. Clinical and economical efficacy of different out-patient management strategy of patients with advanced heart failure. Russian Heart Failure Journal. 2013;14,2(76):89-98. (In Russ.)

19. Packer M, McMurray JJV, Desai AS, et al. PARADIGM-HF Investigators and Coordinators, et al. Angiotensin receptor neprilysin inhibition compared with enalapril on the risk of clinical progression in surviving patients with heart failure. Circulation. 2015;131(1):54-61. doi:10.1161/CIRCULATIONAHA.114.013748.

20. van Diepen S, Bakal JA, Lin M, et al. Variation in critical care unit admission rates and outcomes for patients with acute coronary syndromes or heart failure among highand low-volume cardiac hospitals. Journal of the American Heart Association. 2015;4(3):e001708. doi:10.1161/JAHA.114.001708.

21. McMurray JJV, Packer M, Desai AS, et al. PARADIGM-HF Investigators and Committees Angiotensin-neprilysin inhibition versus enalapril in heart failure. The New England Journal of Medicine. 2014;371(11):993-1004. doi:10.1056/NEJMoa1409077.

22. Federal state statistics service. (In Russ.) URL: http://www.gks.ru/ (accessed on: 13.09.2019).

23. Kalashnikova MF, Belousov DY, Cheberda AE, et al. Pharmacoeconomic analysis of modern oral hypoglycemic agents with inadequate glycemic control on metformin. Kachestvennaya klinicheskaya praktika. 2019;(1):19-44. (In Russ.) doi:10.24411/2588-0519-2019-10062.

24. Setoguchi S, Stevenson LW, Schneeweiss S. Repeated hospitalizations predict mortality in the community population with heart failure. American Heart Journal. 2007;154(2):260-6. doi:10.1016/j.ahj.2007.01.041.

25. Gheorghiade M, Pang PS. Are BNP changes during hospitalization for heart failure a reliable surrogate for predicting the effects of therapies on post-discharge mortality? Journal of the American College of Cardiology. 2009;53(25):2349-52. doi:10.1016/j.jacc.2009.01.075.

26. Ichiki T, Burnett JC. A new signal from B-type natriuretic peptide in ST-elevation myocardial infarction: what does it mean for B-type natriuretic peptide and innovative diagnostics? Circulation. 2010;122(3):229-32. doi:10.1161/CIRCULATIONAHA.110.966358.

27. Biolo A, Fisch M, Balog J, et al. Episodes of acute heart failure syndrome are associated with increased levels of troponin and extracellular matrix markers. Circulation. Heart Failure. 2010;3(1):44-50. doi:10.1161/CIRCHEARTFAILURE.108.844324.

28. Nikolaou M, Parissis J, Yilmaz MB, et al. Liver function abnormalities, clinical profile, and outcome in acute decompensated heart failure. European Heart Journal. 2013;34(10):7429. doi:10.1093/eurheartj/ehs332.

29. Biegus J, Zymliński R, Sokolski M, et al. Liver function tests in patients with acute heart failure. Polskie Archiwum Medycyny Wewnetrznej. 2012;122(10):471-9. doi:10.20452/pamw.1413.

30. Metra M, Cotter G, Davison BA, et al., RELAX-AHF Investigators Effect of serelaxin on cardiac, renal, and hepatic biomarkers in the Relaxin in Acute Heart Failure (RELAX-AHF) development program: correlation with outcomes. Journal of the American College of Cardiology. 2013;61(2):196-206. doi:10.1016/j.jacc.2012.11.005.

31. Damman K, Voors AA, Navis G, et al. Current and novel renal biomarkers in heart failure. Heart Failure Reviews. 2012;17(2):241-50. doi:10.1007/s10741-011-9254-2.


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For citations:


Zyryanov S.K., Ushkalova E.A. Comparative pharmacoeconomic analysis of medication for patients after acute decompensated heart failure. Russian Journal of Cardiology. 2020;25(1):3690. (In Russ.) https://doi.org/10.15829/1560-4071-2020-1-3690

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ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)