Heart failure

Heart Failure Treatment Combo May Reduce Hospitalizations

The treatment combination sacubitril/valsartan (SAC/VAL) may be associated with fewer monthly hospitalizations and lower medical costs compared with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers (ACEI/ARB) in patients with heart failure with reduced ejection fraction (HFrEF), according to new findings.

Researchers arrived at this conclusion following a study of 2 cohorts of 279 stable patients with available claims data from October 2014 to September 2016.
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Propensity scores were used to match SAC/VAL and ACEI/ARB cohorts for demographics, baseline characteristics, and length of follow-up.

Per-patient-per-month (PPPM) hospitalization and healthcare costs were calculated over 3 to 12 months of follow-up, and hospitalization and healthcare costs were compared between cohorts via robust variance estimation.

Results of the study indicated that SAC/VAL-treated patients experienced lower mean PPPM heart failure hospitalizations (0.01 vs 0.03) and all-cause hospitalizations (0.05 vs 0.11) compared with ACEI/ARB-treated patients.

Furthermore, patients in the SAC/VAL cohort had lower mean PPPM all-cause total costs (medical plus outpatient pharmacy costs; $3220 [$4917] vs $4495 [$9911]) and all-cause medical costs ($2273 [$4692] vs $3980 [$9838]) compared with ACEI/ARB-treated patients.

The researchers noted that SAC/VAL treatment was found to incur higher all-cause outpatient pharmacy costs ($947 [$1282] vs $515 [$1041]) compared with ACEI/ARB. However, “reduced monthly medical costs among patients initiated with SAC/VAL offset increased outpatient pharmacy costs, resulting in total lower healthcare costs,” they wrote.

Findings from the study were presented at the Academy of Managed Care Pharmacy Managed Care and Specialty Pharmacy Annual Meeting in Boston, Massachusetts.

—Christina Vogt

Reference:

Albert N, Swindle J, Buysman E, Chang C. Lower hospitalization and total healthcare costs among patients with heart failure when treated with sacubitril/valsartan versus angiotensin-converting enzyme inhibitor or angiotensin-receptor blocker: a retrospective study of managed care claims. Presented at: Academy of Managed Care Pharmacy Managed Care and Specialty Pharmacy Annual Meeting; April 23-26, 2018; Boston, MA. https://www.jmcp.org/doi/pdf/10.18553/jmcp.2018.24.4-a.s1

 

SEE ALSO: Expanding Empagliflozin Use for Heart Failure (Podcast)

 

Dr Thomas Seck, who is the vice president of Clinical Development and Medical Affairs at Boehringer Ingelheim Pharmaceuticals, discusses the EMPERIAL trials, which aim to expand the use of empagliflozin for heart failure.

For more podcasts, click here.