Based on PARADIGM-HF Clinical Trials, LCZ696, a dual-acting sodium
supramolecular complex currently known as sacubitril/valsartan, was
superior to enalapril in reducing the risks of death and hospitalization for
heart failure (HF) in patients with heart failure and reduced ejection fraction
(HFrEF). This analysis aimed to estimate the budget impact of
sacubitril/valsartan in the treatment of HFrEF in Indonesia setting. A budget
impact model estimated the impact with and without the use of
sacubitril/valsartan for a 5-year horizon (2020 – 2024). The local data
inputted in the model included age prevalence rates, drugs costs, HF
hospitalization costs, and adverse events costs. The drug cost calculation of
sacubitril/valsartan was from the regular price, while standard care drug
costs mainly came from e-catalog price, which was reimbursement cost. The
budget impact was estimated from the budget difference between the future
scenario therapy and the current therapy. In the current therapy, the target
population was treated without sacubitril/valsartan. Meanwhile in the future
scenario therapy, the target population was treated with sacubitril/valsartan
based on a market penetration rate of 6%, 12%, 18%, 24%, and 31% in the
first, second, third, fourth and fifth years, respectively.
Given that the number of patients eligible for treatment was estimated as
86,594 in the first year, and the assumption that the annual increase of HF
prevalence was 1.1% based on population growth, about 1,350 deaths and
3,512 hospitalizations may be avoided over five years. The scenario of
implementing sacubitril/valsartan for HF treatment had an impact on an
additional budget of 1%, 2%, 3%, 4%, 5% over a 5-year horizon compared to
the current therapy strategy. This scenario resulted a cumulative budget
impact of IDR 735 billion over five years. This analysis estimates the impact
of sacubitril/valsartan application in the treatment of patients with HF and
reduced ejection fraction as input for Indonesia healthcare payer in
implementing the strategy for HF treatment.
Keywords: sacubitril/valsartan, heart failure with reduced ejection fraction,
budget impact analysis, health technology assessment
