Heart failure & cardiomyopathiesCohort study
Affordability of innovation: cost-effectiveness and budget impact analysis of acoramidis in transthyretin amyloid cardiomyopathy in the German healthcare system
- cost-effectiveness and budget impact analysis
- cohort Markov model (lifetime horizon)
- costs and outcomes discounted at 3% annually
- German statutory health insurance (SHI) system
Authors' conclusion
Despite benefits, acoramidis is unlikely to be cost-effective at current prices in Germany and could increase SHI spending. Price reductions could better align value with affordability.
Study context
- Population
- Patients with transthyretin amyloid cardiomyopathy (ATTR-CM), modelled on randomized-phase ATTRibute-CM data
- Exposure
- Acoramidis vs placebo in the German SHI system
Main finding
As reported in the abstract
Discounted mean lifetime costs · lifetime
placebo
€13 881.50
mean
acoramidis
€828 127.07
mean
- Incremental cost
- €814 245.57
Observational data: associations, not effects.
Further findings
| Outcome | acoramidis | placebo |
|---|---|---|
| QALYs and life-years · lifetime | ||
| QALYs | 4.029 | 2.743 |
| life-years | 6.045 | 4.023 |
- Quality-adjusted Life-years (QALYs) and life-years — Incremental QALYs
- 1.286
- QALYs and life-years — Incremental life-years
- 2.022
Incremental cost-effectiveness ratio (ICER) · lifetime
- ICER
- €633 081 per QALY
Survival scenario analyses (ICER) · lifetime
- Optimistic scenario
- €458 953/QALY
- Pessimistic waning-benefit scenario
- €2 139 712/QALY
Probability of cost-effectiveness at willingness-to-pay (WTP) of €100 000/QALY
- Probability of cost-effectiveness very low; results driven primarily by acoramidis acquisition cost
Budget impact: Year 1 SHI expenditure
- 30% uptake
- €80 813 995
- 50% uptake
- €134 689 992
- 100% uptake
- €269 379 983
Original publication
Affordability of innovation: cost-effectiveness and budget impact analysis of acoramidis in transthyretin amyloid cardiomyopathy in the German healthcare system. Eur Heart J Qual Care Clin Outcomes. Published 2 June 2026. doi:10.1093/ehjqcco/qcag093
Summarised from the published abstract; every number is checked against it