Borer, J. S. et al. (2016) Budget impact of adding ivabradine to standard of care in patients with chronic systolic heart failure in the United States. Journal of Managed Care and Specialty Pharmacy, 22(9), pp. 1064-1071. (doi: 10.18553/jmcp.2016.22.9.1064) (PMID:27574749)
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Abstract
BACKGROUND: Heart failure (HF) costs $21 billion annually in direct health care costs, 80% of which is directly attributable to hospitalizations. The SHIFT clinical study demonstrated that ivabradine plus standard of care (SoC) reduced HF-related and all-cause hospitalizations compared with SoC alone. OBJECTIVE: To estimate the budget impact of ivabradine from a U.S. commercial payer perspective. METHODS: A budget impact model estimated the per-member-per month (PMPM) impact of introducing ivabradine to existing formularies by comparing a reference scenario (SoC) and a new drug scenario (ivabradine + SoC) in hypothetical 1 million-member commercial and Medicare Advantage plans. In both scenarios, U.S. claims data were used for the reference cumulative annual rates of hospitalizations (HF, non-HF cardiovascular [CV], and non-CV), and hospitalization rates were adjusted using SHIFT data. The model controlled for mortality risk using SHIFT and U.S. life table data, and hospitalization costs were obtained from U.S. claims data: HF-related = $37,507; non-HF CV = $28,951; and non-CV = $17,904. The annualized wholesale acquisition cost of ivabradine was $4,500, with baseline use for this new drug at 2%, increasing 2% per year. RESULTS: Based on the approved U.S. indication, approximately 2,000 commercially insured patients from a 1 million-member commercial plan were eligible to receive ivabradine. Ivabradine resulted in a PMPM cost savings of $0.01 and $0.04 in years 1 and 3 of the core model, respectively. After including the acquisition price for ivabradine, the model showed a decrease in total costs in the commercial ($991,256 and $474,499, respectively) and Medicare populations ($13,849,262 and $4,280,291, respectively) in year 1. This decrease was driven by ivabradine’s reduction in hospitalization rates. For the core model, the estimated pharmacy-only PMPM in year 1 was $0.01 for the commercial population and $0.24 for the Medicare Advantage population. CONCLUSIONS: Adding ivabradine to SoC led to lower average annual treatment costs. The negative PMPM budget impact indicates that ivabradine is an affordable option for U.S. payers.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Ford, Professor Ian |
Authors: | Borer, J. S., Kansal, A. R., Dorman, E. D., Krotneva, S., Zheng, Y., Patel, H. K., Tavazzi, L., Komajda, M., Ford, I., Böhm, M., and Kielhorn, A. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre |
Journal Name: | Journal of Managed Care and Specialty Pharmacy |
Publisher: | Academy of Managed Care Pharmacy |
ISSN: | 2376-0540 |
ISSN (Online): | 2376-1032 |
Copyright Holders: | Copyright © 2016 Academy of Managed Care Pharmacy |
First Published: | First published in Journal of Managed Care and Specialty Pharmacy 22(9):1064-1071 |
Publisher Policy: | Reproduced with the permission of the publisher. |
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