Cost-Effectiveness Analysis of Heart Failure Management
Summary
Heart failure represents a growing global health burden characterised by frequent hospital admissions, high mortality and substantial health-care expenditure. Cost-effectiveness analysis applies economic and epidemiological models to compare interventions in terms of both costs and health outcomes, typically expressed as quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Markov cohort or state-transition models are often employed to simulate disease progression, hospitalisation risks and long-term survival under different therapeutic strategies. Analyses routinely incorporate health-state utilities derived from patient-reported instruments, unit costs drawn from local or national databases, and probabilistic sensitivity analyses to assess the robustness of results. Recent emphasis has centred on pharmaceutical innovations such as sodium–glucose co-transporter-2 inhibitors, angiotensin receptor–neprilysin inhibitors and novel agents like ivabradine, alongside non-pharmacological approaches including telemonitoring and device implantation. By evaluating willingness-to-pay thresholds adjusted to regional gross domestic product per capita, cost-effectiveness studies inform reimbursement decisions and clinical guidelines, guiding resource allocation in diverse health-care systems and highlighting strategies that deliver optimal outcomes at acceptable expense.
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Cost-Effectiveness Analysis of Heart Failure Management publication trend
The graph below shows the total number of articles in cost-effectiveness analysis of heart failure management across all publications each year (not limited to Nature Index journals).
Technical terms
Incremental cost-effectiveness ratio (ICER): The additional cost required to gain one extra quality-adjusted life year when comparing two interventions.
Quality-adjusted life year (QALY): A composite measure that combines length of life and health-related quality of life into a single index.
Willingness-to-pay threshold: The maximum amount a health-care payer is prepared to spend to gain one QALY, often based on per-capita economic indicators.
Markov model: A mathematical simulation that represents disease progression through defined health states over discrete time cycles.
Health-state utility: A numerical value reflecting the preference for a given health state, typically derived from patient-reported outcome measures.
References
- Cost-effectiveness of adding empagliflozin to the standard of care for patients with heart failure with reduced ejection fraction from the perspective of healthcare system in Malaysia. Frontiers in Pharmacology (2023).
- A European multinational cost-effectiveness analysis of empagliflozin in heart failure with reduced ejection fraction. The European Journal of Health Economics (2022).
- Economic Evaluation of Dapagliflozin in the Treatment of Patients With Heart Failure: A Systematic Review. Frontiers in Pharmacology (2022).
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