Starting sacubitril-valsartan (Entresto) in patients hospitalized with heart failure with reduced ejection fraction (HFrEF) is not only cost-effective, but actually cost-saving, as compared with outpatient initiation, a new analysis shows.
From a healthcare system perspective, initiation of sacubitril-valsartan during hospitalization saved $452 per year compared with continuing enalapril (Vasotec), and $811 per year compared with initiation at 2 months after hospitalization.
Compared with continuation of enalapril indefinitely, switching patients to sacubitril-valsartan during their HF admission was associated with a cost per quality-adjusted life-year (QALY) gained of $21,532.
“On a short-term basis, initiation of this drug in the hospital both saves money and improves patients’ lives, but even considering a lifetime commitment to the medication, it still offers good value for the money,” said Thomas A. Gaziano, MD, Harvard Medical School, Boston, Massachusetts, lead author of the analysis published online August 12 in JAMA Cardiology.
As modeled in this study,