Department of Pharmacy, Yantai Yuhuangding Hospital, Yantai, Shandong Province, 264000, China.
Department of Hepatological Surgery, Yantai Yuhuangding Hospital, Yantai, Shandong Province, 264000, China.
BMC Public Health. 2024 May 9;24(1):1275. doi: 10.1186/s12889-024-18778-2.
This study aimed to evaluate the cost-utility of the addition of vericiguat for treating chronic heart failure (CHF) in China from the healthcare payer's perspective.
A Markov model was built to estimate the cost and utility of treating CHF using vericiguat plus standard treatment (vericiguat group) vs. standard treatment alone (standard treatment group). The clinical parameters (mortality of cardiovascular and hospitalization rate of HF) were calculated according to the VICTORIA clinical trial. The HF cost and utility data were obtained from the literature published in China. One-way sensitivity analysis and probability sensitivity analysis were performed.
According to the 13-year model, vericiguat was more expensive (155599.07 CNY vs. 259396.83 CNY) and more effective (4.41 QALYs vs. 4.54 QALYs). The incremental cost-utility ratio (ICUR) was 802389.27 CNY per QALY. One-way sensitivity analysis revealed that cardiovascular mortality in the two groups was the parameter that had the greatest impact on the results. The GDP per capita in 2022 in China was 85,700 CNY. The probability sensitivity analysis (PSA) showed that the probability of vericiguat being cost-effective was only 41.7% at the willingness-to-pay (WTP) threshold of 3 times GDP per capita (257,100 CNY).
In China, the treatment of CHF with vericiguat is not cost-effective. The drug price could decrease to 145.8 CNY, which could be considered cost-effective.
本研究旨在从医疗保健支付者的角度评估维立西呱治疗慢性心力衰竭(CHF)的成本-效用。
建立马尔可夫模型,以评估维立西呱联合标准治疗(维立西呱组)与单独标准治疗(标准治疗组)治疗 CHF 的成本和效用。根据 VICTORIA 临床试验计算临床参数(心血管死亡率和 HF 住院率)。HF 成本和效用数据来自中国发表的文献。进行了单因素敏感性分析和概率敏感性分析。
根据 13 年模型,维立西呱的成本更高(155599.07 元比 259396.83 元),效果更好(4.41 QALY 比 4.54 QALY)。增量成本-效用比(ICUR)为每 QALY 802389.27 元。单因素敏感性分析表明,两组心血管死亡率是对结果影响最大的参数。2022 年中国人均国内生产总值(GDP)为 85700 元。概率敏感性分析(PSA)显示,在 3 倍人均 GDP(257100 元)的意愿支付阈值下,维立西呱具有成本效益的概率仅为 41.7%。
在中国,维立西呱治疗 CHF 不具有成本效益。药物价格可降低至 145.8 元,可认为具有成本效益。