PMID- 30560749
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210916
IS  - 1471-6348 (Electronic)
IS  - 0266-4623 (Linking)
VI  - 34
IP  - 6
DP  - 2018
TI  - COST-EFFECTIVENESS ANALYSIS OF IVABRADINE IN TREATMENT OF PATIENTS WITH HEART 
      FAILURE IN IRAN.
PG  - 576-583
LID - 10.1017/S0266462318003598 [doi]
AB  - OBJECTIVES: This study aimed to assess the cost-effectiveness of ivabradine plus 
      standard of care (SoC) in comparison with current SoC alone from the Iranian 
      payer perspective. METHODS: A cohort-based Markov model was developed to assess 
      the incremental cost-effectiveness ratio (ICER) over a 10-year time horizon in a 
      cohort of 1,000 patients. The baseline transition probabilities between New York 
      Heart Association (NYHA), mortality rate, and hospitalization rate were extracted 
      from the literature. The effect of ivabradine on mortality, hospitalization, and 
      NYHA improvement or worsening were retrieved from the SHIFT study. The 
      effectiveness was measured as quality-adjusted life-years (QALYs) using the 
      utility values derived from Iranian Heart Failure Quality of Life study. Direct 
      medical costs were obtained from hospital records and national tariffs. 
      Deterministic and probabilistic sensitivity analyses were conducted to show the 
      robustness of the model. RESULTS: Ivabradine therapy was associated with an 
      incremental cost per QALY of USD $5,437 (incremental cost of USD $2,207 and QALYs 
      gained 0.41) versus SoC. The probabilistic sensitivity analysis showed that 
      ivabradine is expected to have a 60 percent chance of being cost-effective 
      accepting a threshold of USD $6,550 per QALY. Furthermore, deterministic 
      sensitivity analysis indicated that the model is sensitive to the ivabradine drug 
      acquisition cost. CONCLUSIONS: The cost-effectiveness model suggested that the 
      addition of ivabradine to SoC therapy was associated with improved clinical 
      outcomes along with increased costs. The analysis indicates that the clinical 
      benefit of ivabradine can be achieved at a reasonable cost in eligible heart 
      failure patients with sinus rhythm and a baseline heart rate >/= 75 beats per 
      minute (bpm).
FAU - Taheri, Saeed
AU  - Taheri S
AD  - Department of pharmacoeconomics and pharma management, School of pharmacy, Shahid 
      Beheshti university of medical scienceStudents' research committee, Shahid 
      Beheshti university of medical science.
FAU - Heidari, Elham
AU  - Heidari E
AD  - Non-Communicable Disease Research Center, Endocrinology and Metabolism Population 
      Sciences Institute, Tehran University of Medical Sciences.
FAU - Aivazi, Mohammad Ali
AU  - Aivazi MA
AD  - Department of pharmacoeconomics and pharma management, School of pharmacy, Shahid 
      Beheshti university of medical science.
FAU - Shams-Beyranvand, Mehran
AU  - Shams-Beyranvand M
AD  - Dezful University of Medical Sciences,Non-Communicable Disease Research Center, 
      Endocrinology and Metabolism Population Sciences Institute, Tehran University of 
      Medical Sciences.
FAU - Varmaghani, Mehdi
AU  - Varmaghani M
AUID- ORCID: 0000-0001-6249-821X
AD  - Social Determinants of Health Research Center, Mashhad University of Medical 
      Sciences Non-Communicable Disease Research Center, Endocrinology and Metabolism 
      Population Sciences Institute, Tehran University of Medical 
      Sciencesvarmaghanim@mums.ac.ir.
LA  - eng
PT  - Journal Article
DEP - 20181218
PL  - England
TA  - Int J Technol Assess Health Care
JT  - International journal of technology assessment in health care
JID - 8508113
SB  - IM
OTO - NOTNLM
OT  - Cost-effectiveness analysis
OT  - Heart failure
OT  - Iran
OT  - Ivabradine
EDAT- 2018/12/19 06:00
MHDA- 2018/12/19 06:01
CRDT- 2018/12/19 06:00
PHST- 2018/12/19 06:00 [pubmed]
PHST- 2018/12/19 06:01 [medline]
PHST- 2018/12/19 06:00 [entrez]
AID - S0266462318003598 [pii]
AID - 10.1017/S0266462318003598 [doi]
PST - ppublish
SO  - Int J Technol Assess Health Care. 2018;34(6):576-583. doi: 
      10.1017/S0266462318003598. Epub 2018 Dec 18.