| Title |
Cost-Effectiveness Analysis of Patiromer and Spironolactone Therapy in Heart Failure Patients with Hyperkalemia
|
|---|---|
| Published in |
PharmacoEconomics, September 2018
|
| DOI | 10.1007/s40273-018-0709-3 |
| Pubmed ID | |
| Authors |
Mark Bounthavong, Javed Butler, Chantal M. Dolan, Jeffrey D. Dunn, Kathryn A. Fisher, Nina Oestreicher, Bertram Pitt, Paul J. Hauptman, David L. Veenstra |
| Abstract |
Certain patients with heart failure (HF) are unable to tolerate spironolactone therapy due to hyperkalemia. Patiromer is a novel agent used to treat hyperkalemia and has been shown to be efficacious, safe, and well-tolerated. The potential clinical outcomes and economic value of using patiromer and spironolactone in patients with HF unable to otherwise tolerate spironolactone due to hyperkalemia are unclear. The objective of this analysis was to model the potential pharmacoeconomic value of using patiromer and spironolactone in patients with a history of hyperkalemia that prevents them from utilizing spironolactone. We performed a cost-effectiveness analysis of treatment with patiromer, spironolactone, and an angiotensin-converting enzyme inhibitor (ACEI) in patients with New York Heart Association (NYHA) class III-IV HF compared with ACEI alone. A Markov model was constructed to simulate a cohort of 65-year-old patients diagnosed with HF from the payer perspective across the lifetime horizon. Clinical inputs were derived from the RALES and OPAL-HK randomized trials of spironolactone and patiromer, respectively. Utility estimates and costs were derived from the literature and list prices. Outcomes assessed included hospitalization, life expectancy, and quality-adjusted life-years (QALYs), costs, and the incremental cost-effectiveness ratio (ICER). One-way and probability sensitivity analyses were performed to test the robustness of the model findings. Treatment with patiromer-spironolactone-ACEI was projected to increase longevity compared with ACEI alone (5.29 vs. 4.62 life-years gained, respectively), greater QALYs (2.79 vs. 2.60), and costs (US$28,200 vs. US$18,200), giving an ICER of US$52,700 per QALY gained. The ICERs ranged from US$40,000 to US$85,800 per QALY gained in 1-way sensitivity analyses. Our results suggest that the use of spironolactone-patiromer-ACEI may provide clinical benefit and good economic value in patients with NYHA class III-IV HF unable to tolerate spironolactone due to hyperkalemia. |
X Demographics
The data shown below were collected from the profiles of 23 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 8 | 35% |
| Ecuador | 1 | 4% |
| United Kingdom | 1 | 4% |
| Canada | 1 | 4% |
| United States | 1 | 4% |
| Unknown | 11 | 48% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 19 | 83% |
| Practitioners (doctors, other healthcare professionals) | 2 | 9% |
| Scientists | 2 | 9% |
Mendeley readers
The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 52 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Ph. D. Student | 8 | 15% |
| Student > Bachelor | 8 | 15% |
| Other | 5 | 10% |
| Researcher | 4 | 8% |
| Student > Doctoral Student | 2 | 4% |
| Other | 7 | 13% |
| Unknown | 18 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 29% |
| Pharmacology, Toxicology and Pharmaceutical Science | 6 | 12% |
| Business, Management and Accounting | 2 | 4% |
| Economics, Econometrics and Finance | 2 | 4% |
| Computer Science | 1 | 2% |
| Other | 6 | 12% |
| Unknown | 20 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 July 2022.
All research outputs
#2,202,317
of 24,089,711 outputs
Outputs from PharmacoEconomics
#155
of 1,942 outputs
Outputs of similar age
#45,779
of 339,690 outputs
Outputs of similar age from PharmacoEconomics
#8
of 30 outputs
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So far Altmetric has tracked 1,942 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.2. This one has done particularly well, scoring higher than 92% of its peers.
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