PCV23 Budget IMPACT Analysis of Sacubitril Valsartan for Heart Failure Treatment in Indonesia

Abstract

Based on PARADIGM-HF Clinical Trials, LCZ696 a dual-acting sodium supramolecular complex which currently known as sacubitril valsartan, was superior to enalapril in reducing the risks of death by 20% and of hospitalization for heart failure (HF) by 21% in patients with heart failure and reduced ejection fraction (HFrEF). This analyze aims to estimate the budget impact of sacubitril/valsartan in the treatment of HFrEF from the perspective of Indonesia healthcare payer. A budget impact model estimated the impact with and without use of sacubitril valsartan for 5-year horizon (2020 – 2024). The local data inputted in the model were including age prevalence rates, drugs costs, HF hospitalization cost, and adverse events costs. The drug cost calculation of sacubitril valsartan was coming from regular price, while drugs costs of standard of care were mostly coming from reimbursement cost. The budget impact was estimated from the difference budget in which the target population is treated with the current therapy (without sacubitril valsartan) and the future scenario in which the target population is treated with sacubitril valsartan based in a market penetration rate of 9%, 19%, 28%, 38%, and 47% in the first, second, third, fourth and fifth years, respectively. Given the number of patients eligible for treatment was estimated as 86,594 in the first year and assumption of annual increase of HF prevalence was 1.1% based on population growth, about 2,092 deaths and 5,444 hospitalizations may be avoided over 5 years. The scenario of implementing sacubitril valsartan for HF treatment had impact of additional budget (of drug cost) of 2%, 4%, 5%, 6%, 7% over 5-year horizon compared to current therapy strategy. This analysis provides estimation of budget impact of implementing sacubitil valsartan in the treatment of patients with HFrEF as an input for Indonesia healthcare payer in implementing strategy for HF treatment.