Cost-Effectiveness of Ivabradine for Heart Failure in the United States

Background: ivabradine is a heart rate-lowering agent approved to reduce the risk of hospitalization for worsening heart failure. this study assessed the cost-effectiveness of adding ivabradine to background therapy in the united states from the perspective of a commercial or medicare advantage payer. methods and results: a cost-effectiveness,cohort-based markov model using a state transition approach tracked a cohort of heart failure patients with heart rate ≥70 beats per minute in sinus rhythm who were treated with ivabradine+background therapy or background therapy alone. model inputs,including adjusted hazard ratios,rates of hospitalization and mortality,adverse events,and utility-regression equations,were derived from a large us claims database and shift (systolic heart failure treatment with the if inhibitor ivabradine trial). in the commercial population,ivabradine+background therapy was associated with a cost savings of $8594 versus the cost of background therapy alone over a 10-year time horizon,primarily because of reduced hospitalization. ivabradine was associated with an incremental benefit of 0.24 quality-adjusted life years over a 10-year time horizon. in the medicare advantage population,the incremental cost-effectiveness ratio for ivabradine was estimated to be $24 920/quality-adjusted life years. conclusions: the cost-effectiveness model suggests that for a commercial population,the addition of ivabradine to background therapy was associated with cost savings and improved clinical outcomes. for a medicare advantage population,the analysis indicates that the clinical benefit of ivabradine can be achieved at a reasonable cost. © 2016 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.