The new Novartis heart failure drug Entresto (the combination of sacubitril and valsartan, formerly known as LCZ696) is cost effective but the CardioMEMS monitoring system (St. Jude Medical) is not, according to draft reports issued last week by the Institute for Clinical and Economic Review (ICER). The same organization released a widely discussed report about the cost effectiveness of the new PCSK9 inhibitors.
LCZ696 won’t save healthcare dollars long term, but the list price of $4,560 per year is in line with the “small to substantial net health benefit” over the current standard of care in reducing heart failure hospitalizations and deaths, the report suggested.
However, given that nearly 2 million heart failure patients would be candidates for the drug in its first 5 years on the market, the “value-based price benchmark” to keep the budget impact in line with national economic growth should be $3,779. The estimated cost per quality-adjusted life-year gained was about $51,000.
That 17% differential is likely achievable with the usual price deductions for large volume purchasers, the report suggested.
For the CardioMEMS pulmonary artery pressure sensor, the analysis concluded there was “insufficient” evidence for an improvement in overall patient outcomes and thus “excessive cost” to the healthcare system. The estimated cost per quality-adjusted life-year gained was about $58,000.
In order for expected use to pull even with the budget impact, the $17,750 list price would need to be discounted 57% to $7,622.