Brandon K. Bellows

Cost-Effectiveness of Sacubitril-Valsartan Combination Therapy Compared With Enalapril for the Treatment of Heart Failure With Reduced Ejection Fraction.

OBJECTIVES The objective of this study was to determine the cost-effectiveness and cost per quality-adjusted life year (QALY) gained of sacubitril-valsartan relative to enalapril for treatment of heart failure with reduced ejection fraction (HFrEF). BACKGROUND Compared with enalapril, combination angiotensin receptor-neprilysin inhibition (ARNI), as is found in sacubitril-valsartan, reduces cardiovascular death and heart failure hospitalization rates in patients with HFrEF. METHODS Using a Markov model, costs, effects, and cost-effectiveness were estimated for sacubitril-valsartan and enalapril therapies for the treatment of HFrEF. Patients were 60 years of age at model entry and were modeled over a lifetime (40 years) from a third-party payer perspective. Clinical probabilities were derived predominantly from PARADIGM-HF (Prospective Comparison of ARNI With ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure). All costs and effects were discounted at a 3% rate annually and are presented in 2015 U.S. dollars. RESULTS In the base case, sacubitril-valsartan, compared with enalapril, was more costly (

Cost-effectiveness of intensive versus standard blood-pressure control

60,391 vs.

Evaluation of the relationship between weight change and glycemic control after initiation of antidiabetic therapy in patients with type 2 diabetes using electronic medical record data

21,758) and more effective (6.49 vs. 5.74 QALYs) over a lifetime. The cost-effectiveness of sacubitril-valsartan was highly dependent on duration of treatment, ranging from

Antihyperlipidemic Medication Treatment Patterns and Statin Adherence Among Patients with ASCVD in a Managed Care Plan After Release of the 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol

249,411 per QALY at 3 years to

A Cost-Utility Analysis of Pregabalin Versus Duloxetine for the Treatment of Painful Diabetic Neuropathy

50,959 per QALY gained over a lifetime. CONCLUSIONS Sacubitril-valsartan may be a cost-effective treatment option depending on the willingness-to-pay threshold. Future investigations should incorporate real-world evidence with sacubitril-valsartan to further inform decision making.

Real-World Evidence in Pain Research: A Review of Data Sources

BACKGROUND In the Systolic Blood Pressure Intervention Trial (SPRINT), adults at high risk for cardiovascular disease who received intensive systolic blood‐pressure control (target, <120 mm Hg) had significantly lower rates of death and cardiovascular disease events than did those who received standard control (target, <140 mm Hg). On the basis of these data, we wanted to determine the lifetime health benefits and health care costs associated with intensive control versus standard control. METHODS We used a microsimulation model to apply SPRINT treatment effects and health care costs from national sources to a hypothetical cohort of SPRINT‐eligible adults. The model projected lifetime costs of treatment and monitoring in patients with hypertension, cardiovascular disease events and subsequent treatment costs, treatment‐related risks of serious adverse events and subsequent costs, and quality‐adjusted life‐years (QALYs) for intensive control versus standard control of systolic blood pressure. RESULTS We determined that the mean number of QALYs would be 0.27 higher among patients who received intensive control than among those who received standard control and would cost approximately

Evaluation of cardiovascular risk factors, events, and costs across four BMI categories.

47,000 more per QALY gained if there were a reduction in adherence and treatment effects after 5 years; the cost would be approximately

Healthcare costs and resource utilization of patients with binge‐eating disorder and eating disorder not otherwise specified in the Department of Veterans Affairs

28,000 more per QALY gained if the treatment effects persisted for the remaining lifetime of the patient. Most simulation results indicated that intensive treatment would be cost‐effective (51 to 79% below the willingness‐to‐pay threshold of

A review of the clinical utility of duloxetine in the treatment of diabetic peripheral neuropathic pain.

50,000 per QALY and 76 to 93% below the threshold of

Determinants of glycaemic control in a practice setting: the role of weight loss and treatment adherence (The DELTA Study).

100,000 per QALY), regardless of whether treatment effects were reduced after 5 years or persisted for the remaining lifetime. CONCLUSIONS In this simulation study, intensive systolic blood‐pressure control prevented cardiovascular disease events and prolonged life and did so at levels below common willingness‐to‐pay thresholds per QALY, regardless of whether benefits were reduced after 5 years or persisted for the patients remaining lifetime. (Funded by the National Heart, Lung, and Blood Institute and others; SPRINT ClinicalTrials.gov number, NCT01206062.)