Heart failure & cardiomyopathiesResearch article
Cost-Effectiveness of Tafamidis Therapy for Transthyretin Amyloid Cardiomyopathy
- Cost-effectiveness analysis (Markov model)
- US healthcare sector perspective
- lifetime horizon
- 3% annual discounting
- deterministic and probabilistic sensitivity analyses
Authors' conclusion
Treatment with tafamidis is projected to produce substantial clinical benefit but would greatly exceed conventional cost-effectiveness thresholds at the current US list price.
Study context
- Population
- Patients with wild-type or variant transthyretin amyloid cardiomyopathy and HF (mean age, 74.5 years); model inputs from ATTR-ACT
- Comparison
- Tafamidis vs usual care
- Outcome
- Lifetime incremental cost-effectiveness ratio and annual budget impact
Main finding
As reported in the abstract
Incremental cost-effectiveness · lifetime
- uncertainty interval
- incremental QALYs 1.29 quality-adjusted life-years (95% UI 0.47–1.75)
- Incremental cost-effectiveness
- incremental cost $1 135 000 (UI 872 000-1 377 000)
- Incremental cost-effectiveness
- incremental cost-effectiveness ratio $880 000 per quality-adjusted life-year gained (UI 697 000-1 564 000)
- Annual budget impact of treating all eligible US patients (n=120 000): increase in healthcare spending
- $32.3 billion
Further findings
Probabilistic sensitivity analysis at $100 000/QALY threshold
- Tafamidis cost-effective at current price, % of 10 000 simulations
- 0%
- Price reduction needed for cost-effectiveness at $100 000/QALY (from $225 000 to $16 563)
- 92.6%
- Results sensitive to assumptions on long-term effectiveness of tafamidis
Original publication
Cost-Effectiveness of Tafamidis Therapy for Transthyretin Amyloid Cardiomyopathy. Circulation. Published 12 February 2020. doi:10.1161/circulationaha.119.045093
Summarised from the published abstract; every number is checked against it