News | Heart Failure | September 16, 2015

Cost-effectiveness of CardioMEMS and Entresto for Heart Failure Management Reviewed

Report suggests price benchmarks to maximize both costs and improved outcomes in the long term

ICER, CardioMEMS, Entresto, congestive heart failure, cost-effectiveness

CardioMEMS image courtesy of St. Jude Medical.

September 16, 2015 — The Institute for Clinical and Economic Review (ICER) has released a new report offering a comprehensive review of currently available evidence on two new interventions as potential advances in the care of congestive heart failure (CHF) patients. The report is titled CardioMEMS HF System (St. Jude Medical) and Sacubitril/Valsartan (Entresto, Novartis) for Management of Congestive Heart Failure: Effectiveness, Value, and Value-Based Price Benchmarks.

The first system discussed, known as CardioMEMS, monitors increases in pulmonary artery pressure (a key indicator of worsening CHF) , and the second is the medication sacubitril/valsartan (Entresto) to treat CHF. The ICER report provides analyses of long-term cost-effectiveness and the potential budget impact of these new interventions. In addition, the results of these analyses are used to calculate a value-based price benchmark for each intervention.  These price benchmarks reflect estimates of how much better the interventions are at improving patient outcomes, tempered by thresholds at which additional new costs would contribute to growth in healthcare costs exceeding growth in the overall national economy.

CHF represents a major public health concern, currently affecting nearly 6 million individuals in the United States.  Growth in per capita medical spending and aging of the population are expected to contribute to substantial increases in the direct medical costs of treating CHF, with annual costs totaling nearly $80 billion by 2030.

"Figuring out the effectiveness and value of new drugs and devices is not merely an academic exercise," noted Steven D. Pearson, M.D., MSc, founder and president of ICER.  "The headlines are full of stories about rising healthcare costs and their impact on patients, families, and the budgets of states and the federal government.  A clear-eyed view of the evidence is critical to all members of the healthcare community as we try to figure out what should be used, which patients benefit most and at what price innovative treatments represent a reasonable value."

ICER's analysis concludes that there is moderate certainty that Entresto provides a small to substantial net health benefit compared to the current standard of care in patients with CHF. Entresto increases the average length of life for patients and also decreases the number of hospitalizations for CHF. At the list price of $4,560 per year, Entresto does not save money over the long term but its added costs are well-aligned with the degree of benefit it brings to patients. This means Entresto can be judged "cost-effective" in the long term according to commonly accepted cost-effectiveness thresholds.

However, ICER's analysis predicts that nearly 2 million patients could be prescribed Entresto over the first five years, creating a total budget impact so high that excessive cost burdens would be placed on the overall healthcare system. In order to keep healthcare cost growth in line with growth in the national economy, ICER's value-based price benchmark for Entresto is $3,779 annually, a 17 percent discount off the list price.  Private insurers and Medicaid programs are frequently able to achieve discounts at this level.

Regarding the CardioMEMS HF System, the ICER analysis concludes that the current evidence is "insufficient" to be able to determine that it improves overall patient outcomes. If the device is used, however, at a list price of $17,750, it would also exceed the threshold for potential budget impact that indicates an excessive cost to the overall healthcare system. As Pearson noted, "When estimated patterns of CardioMEMS uptake are considered, our value-based price benchmark for CardioMEMS comes in at $7,622, a nearly 60 percent discount off the current list price."

The draft report, as well as accompanying draft voting questions, will be open to public comment until Sept. 25, 2015.

For more information: www.icer-review.org

Related Content

Cardiac Dimensions Randomizes First Patient in CARILLON Trial of Mitral Contour System
News | Heart Failure | September 20, 2018
Cardiac Dimensions announced the company has randomized its first patient in the CARILLON Pivotal Trial.
Antithrombin Drug Ineffective in Heart Failure With Sinus Rhythm and Coronary Disease
News | Heart Failure | September 07, 2018
The antithrombin drug rivaroxaban does not reduce the risk of a composite endpoint of survival, myocardial infarction...
Tafamidis Improves Survival in Rare Heart Condition
News | Heart Failure | September 06, 2018
Tafamidis is the first treatment to improve survival and reduce hospitalizations in a rare heart condition called...
New Target for Treating Heart Failure Identified by Penn Medicine Researchers

Microtubules in heart cells from a healthy patient (left) and from a patient with heart failure. The dense network of detyrosinated microtubules impedes the motion of the failing heart cell during the heart beat. Credit: Ben Prosser lab, Perelman School of Medicine, University of Pennsylvania

News | Heart Failure | June 25, 2018
New research finds changes in cellular struts called microtubules (MT) can affect the stiffness of diseased human heart...
Gencaro Does Not Reduce Atrial Fibrillation Risk in Heart Failure Patients
News | Heart Failure | May 30, 2018
Data from the GENETIC-AF trial was presented in a “Late Breaking Clinical Trials” oral presentation at the European...
Cardiac Contractility Modulation Safe and Effective as Heart Failure Treatment

Image courtesy of Impulse Dynamics

News | Heart Failure | May 18, 2018
In a new study, cardiac contractility modulation (CCM) therapy was confirmed to significantly improve exercise...
V-Wave Closes $70M Financing to Support Pivotal Study of Heart Failure Therapy
News | Heart Failure | May 16, 2018
Israel-based V-Wave Ltd. recently closed a $70 million Series C financing for its proprietary, minimally invasive...
News | Heart Failure | May 14, 2018
Ancora Heart Inc. announced the expansion of the company’s U.S. feasibility study to evaluate the investigational...
Protein Clumping May Contribute to Heart Failure Development

A PET scan detects clumping proteins in rat hearts (top). The enlarged heart (right) is one with heart failure. Other PET scans showing blood flow in the rat hearts (bottom) show that the protein clumps aren't due to circulation problems. Image courtesy of Circulation Research, May 11, 2018.

News | Heart Failure | May 11, 2018
A team led by Johns Hopkins University Researchers has discovered that protein clumps appear to accumulate in the...
Overlay Init