Impact of Different Markov Models and Medical Insurance Negotiation Access before and after on Economy of Vericiguat in the Treatment of HFrEF
Objective To evaluate the impact of two Markov models,before and after the national medical insurance system's drug list access negotiation of vericiguat on the economy of vericiguat plus the standard treatment in the treatment of heart failure with reduced ejection fraction(HFrEF)in China.Methods On the basis of the clinical trial results of VICTORIA and previous literature,three-state and five-state Markov models with a cycle length of one month and a time period of twenty years were established.The model simulated the direct medical costs and quality adjusted life years(QALYs)of the standard treatment group and vericiguat plus the standard treatment group in the treatment of heart failure with reduced ejection fraction.The cost-utility analysis method was used to evaluate the economy of vericiguat before and after being included in medical insurance,and the stability of the results has been validated through sensitivity analysis.Results In the analysis of the economic impact of vericiguat after its inclusion in medical insurance using three-state and five-state Markov models,the incremental cost-utility ratios(ICUR)for the vericiguat group,compared to the standard treatment group,were 91 188.99 yuan/QALY and 106 086.87 yuan/QALY,respectively.All of them were less than 3 times the domestic per capita GDP(257 094 yuan),so the treatment of HFrEF was economical.When further analyzing the economic implications of vericiguat before its inclusion in medical insurance using the five-state Markov model,the ICUR for the empagliflozin group relative to the standard treatment group were 552 879.96 yuan/QALY,which is more than 3 times the domestic per capita GDP(257,094 yuan),so the treatment of HFrEF in Vericigua group is not economical.The sensitivity analysis results were consistent with the base analysis results.Conclusion In evaluating the economy of the vericiguat plus the standard treatment for HFrEF in China,the two Markov models showed a relatively small impact on their economy.However,inclusion in medical insurance negotiation access made it more cost-effective,significantly reducing the patient's payment burden.
VericiguatMarkov modelNational medical insurance negotiated drugHeart failure with reduced ejection fractionCost-utility analysis
国家科技期刊平台
NSTL
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