Table 1.
Overview of economic models reported in publications
| Study, country | Disease classification system | HF type | Model specifications | Modelling outcomes assessed | Type of scenario/sensitivity analysis | Key model drivers |
|---|---|---|---|---|---|---|
| Erhardt et al. [63] Sweden | NYHA | Unclear |
Core model/adaptation: Adaptation Study type: Cost effectiveness Model type: ‘Real-world’ partition survival analysis Perspective: Third-party payer Time horizon: 3.8 years Discount rate: 5% for both costs and health outcomes |
LYG, costs, ICERs, WTP | OWSA; the key model drivers were varied to establish their effect on the outcome | Hospital costs Number of rehospitalizations for HF |
| Schadlich et al. [70] Germany | NYHA | Unclear |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Partition survival model Perspective: Payer Time horizon: 3.8 years Discount rate: 5% for costs |
LYG, costs, ICERs | DSA Weibull estimation of survival probability and LYG |
Treatment duration Number of rehospitalizations per patient Inpatient treatment for decompensated HF |
| Anderson et al. [53] South Africa | NYHA | Unclear |
Core model/adaptation: Adaptation Study type: Cost utility Model type: Partition survival model Perspective: Third-party payer Time horizon: 3.8 years Discount rate: 0%, 5% and 10% for costs. 5% for health outcomes |
LYG, costs, ICERs | Analysis established best- and worst-case scenarios | Treatment duration |
| Hart et al. [65] Spain | NYHA | Unclear |
Core model/adaptation: Adaptation Study type: Cost effectiveness Model type: Area under the survival curve analysis of survival and rehospitalization probability Perspective: Payer Time horizon: 3.8 years Discount rate: 6% for both costs and health outcomes |
LYG, costs, ICERs | Establishes the effect of additional costs and non-hospital costs on the ICER for the intervention | Treatment duration Length of hospital stay |
| Ademi et al. [51] Australia | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with four transition states with 1-year cycle lengths Perspective: Payer Time horizon: 10 years Discount rate: 5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Univariate analysis | Efficacy measures (predominantly those regarding CV mortality) Drug cost |
| Ademi et al. [52] Australia | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Five-health-state Markov model with 1-year cycle lengths Perspective: Payer Time horizon: 10 years Discount rate: 5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Scenario analysis | Number of hospitalizations |
| Lee et al. [41] UK and Spain | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Discrete-event simulation model determining risk of hospitalization for HF, new-onset of AF, AEs, treatment discontinuation, and mortality Perspective: Payers Time horizon: Lifetime Discount rate: 3.5% for health outcomes for the UK model and 3% for the Spanish model |
QALYs, LYG, costs, ICERs, WTP | DSA and PSA | Drug cost Cost of disease management and monitoring Number of hospitalizations |
| Thanh et al. [50] Canada | Unclear | Unclear |
Core model/adaptation: Adaptation Study type: Cost utility Model type: Discrete-event simulation model of hospitalizations, AEs, AF, device implantation, discontinuation, and death Perspective: Healthcare Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Scenario analysis and OWSA | Drug cost Scale parameters of Weibull distributions estimating time to event of device implantation CV hospitalization for patients receiving intervention |
| CADTH [47] Canada | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Discrete-event simulation model of hospitalization, AEs, discontinuation, and AF, resulting in either mortality or device implantation Perspective: Ministry of Health (governmental) Time horizon: Lifetime Discount rate: 5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs | DSA and PSA | Not reported |
| SMC [35] Scotland | Unclear | Unclear |
Core model/adaptation: Core model Study type: Cost utility Model type: Discrete-event simulation model Perspective: NHS Time horizon: Lifetime Discount rate: Not reported |
QALYs, costs, ICERs | Scenario analysis | Mortality |
| AWMSG [31] Wales | Unclear | Unclear |
Core model/adaptation: Core model Study type: Cost utility Model type: Discrete-event simulation model Perspective: NHS Time horizon: Lifetime Discount rate: 3.5% on both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | OWSA | Distribution parameters for CV mortality Number of HF hospitalizations Utility decrements associated with age |
| Weintraub et al. [29] USA | Unclear | Unclear |
Core model/adaptation: Core model Study type: Cost utility Model type: Trial- and registry-based analysis Perspective: Societal Time horizon: 16 months Discount rate: 3% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Bootstrap analysis | Age Use of blocker treatment after AMI Use of life-saving interventions |
| de Pouvourville et al. [61] France | Unclear | Unclear |
Core model/adaptation: Adaptation Study type: Cost utility Model type: Trial- and registry-based analysis Perspective: Partially societal Time horizon: 16 months Discount rate: 5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs | PSA | Long-term survival |
| Zhang et al. [30] USA | Unclear | Unclear |
Core model/adaptation: Adaptation Study type: Cost utility Model type: Trial-based analysis Perspective: Societal Time horizon: 16 months Discount rate: 3% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Not reported | Post-trial costs |
| McKenna et al. [44] UK | Unclear | Unclear |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with 1-year cycle lengths Perspective: NHS Time horizon: Lifetime Discount rate: 3.5% for both costs and health outcomes |
QALYs, costs, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Treatment efficacy |
| Ollendorf et al. [25] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Payers Time horizon: Lifetime Discount rate: Not reported |
QALYs, costs, ICERs, WTP, VBP | Sensitivity analysis was not specified but established key model drivers | Assumed duration of improved outcomes with the intervention (sacubitril/valsartan) |
| King et al. [23] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model using NYHA disease classification and death to establish health states with 3-month cycle lengths Perspective: Third-party payer Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | DSA and PSA | Probability of CV death |
| Sandhu et al. [27] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model of hospitalization reasons, ED visit for HF and death, with 1-month cycle lengths Perspective: Societal Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Survival |
| Ramos et al. [69] Netherlands | NYHA | Chronic |
Core model/adaptation: Adaptation Study type: Cost utility Model type: Markov model with a half-cycle correction and 1-month cycle lengths Perspective: Societal Time horizon: Lifetime Discount rate: 4% for costs and 1.5% for health outcomes |
QALYs, LYG, costs, ICERs, WTP | Scenario analysis | Hospitalization Mortality |
| van der Pol et al. [75] Netherlands | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with four health states and 1-month cycle lengths Perspective: Healthcare payer Time horizon: Lifetime Discount rate: 4% for costs and 1.5% for health outcomes |
QALYs, LYG, costs, ICERs, WTP, VBP | Univariate analysis | Risk of death Utility of patients who are not hospitalized QALYs |
| NICE [32] England | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with a half-cycle correction and 1-month cycle lengths Perspective: NHS Time horizon: Lifetime Discount rate: 3.5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Treatment effect The constant term in the statistical model of all-cause mortality |
| SMC [33] Scotland | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Two-state, alive and dead, Markov model Perspective: NHS Time horizon: Lifetime Discount rate: Not reported |
QALYs, costs, ICERs | A range of sensitivity analyses and scenario analysis | Survival estimates Duration of treatment effect Time horizon |
| ICER [15] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with 1-month cycle lengths Perspective: Third-party payer Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP, VBP | Sensitivity analysis was not specified but established key model drivers | Duration of treatment effect Price of drug |
| Varney [46] UK | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: NHS Time horizon: 5 years Discount rate: 6% for both costs and health outcomes |
LYG, costs, ICERs | Sensitivity analysis was not specified but established key model drivers | Annual rate of hospitalization |
| Ekman et al. [62] Sweden | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Societal Time horizon: 2.3 years Discount rate: 3% for both costs and health outcomes. Costs occurring within the context of the clinical trial have not been discounted |
LYG, costs, ICERs, WTP | OWSA | Cost of life-years gained |
| Polistena et al. [73] Italy | NYHA | Chronic |
Core model/adaptation: Adaptation Study type: Cost effectiveness Model type: Markov model Perspective: NHS Time horizon and discount rate: Not reported |
QALYs, LYG, costs, ICERs, WTP | PSA | Not reported |
| Kansal et al. [22] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with 1-month cycle lengths Perspective: Payer Time horizon: 10 years Discount rate: Not reported |
QALYs, LYG, costs, ICERs, WTP | PSA | Time horizon Treatment effect on HF hospitalization and mortality |
| Edwards et al. [39] England | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Alive and dead Markov model, with half-cycle correction and 1-month cycle lengths Perspective: NHS Time horizon: Lifetime Discount rate: 3.5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | DSA and PSA | Treatment effect |
| SMC [34] Scotland | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model Perspective: NHS Time horizon: Lifetime Discount rate: Not reported |
QALYs, costs, ICERs | Not reported | Not reported |
| Backhouse et al. [36] UK | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: NHS Time horizon: 5 years Discount rate: 6% for both costs and health outcomes |
LYG, costs, ICERs | Sensitivity analysis was not specified but established key model drivers | Long-term survival |
| Malik et al. [43] UK | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness and cost consequence Model type: Trial-based analysis Perspective: NHS Time horizon: Lifetime Discount rate: 6% for both costs and health outcomes |
ICERs, WTP | OWSA | Cost of drug |
| Lamy et al. [24] USA and Canada | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Third-party payer Time horizon: 4.5 years Discount rate: 3% for costs |
Costs, ICERs, WTP | Not reported | Not reported |
| Bjorholt et al. [54] Sweden | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Societal Time horizon: 4.5 years Discount rate: 3% for both costs and health outcomes |
LYG, costs, ICERs, WTP | Not specified | Not reported |
| Beard et al. [37] UK | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: NHS Time horizon: 5 years Discount rate: 6% for both costs and health outcomes |
LYG, costs, ICERs, WTP | Not specified | Not reported |
| Grover et al. [48] Canada | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with 1-year cycle lengths Perspective: NHS Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
QALYs, LYG, ICERs | Not reported | Long-term survival |
| Colombo et al. [57] Italy | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trials-based analysis Perspective: NHS Time horizon: 2 years Discount rate: 3% for both costs and health outcomes |
LYG, costs, ICERs | Sensitivity analysis was not specified but established key model drivers | Hospital admissions |
| Angus et al. [16] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Societal Time horizon: 18 months Discount rate: 3% for both costs and health outcomes |
LYG, costs, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Cost of drug Cost of hospital stay |
| Borghi et al. [55] multi-country | Killip | Mixed |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Third-party payer Time horizon: 12 months Discount rate: Not reported |
Costs, ICERs, WTP | Not specified | Not reported |
| Pradelli et al. [68] Italy | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model using NYHA disease classification and death to establish health states with 1-month cycle lengths Perspective: NHS Time horizon: 10 years Discount rate: 3.5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Hospitalization |
| Lorgelly et al. [42] UK | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: NHS Time horizon: 3 years Discount rate: 3.5% for both costs and health outcomes |
LYG, costs, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Cost of statin treatment, hospitalizations and procedures for major CV events |
| de Lissovoy et al. [18] USA | NYHA | Acute |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Hospital Time horizon: Lifetime Discount rate: Not reported |
LYG, costs, ICERs | Sensitivity analysis was not specified but established key model drivers | Cost of treatment Long-term survival |
| de Lissovoy et al. [60] multi-country | Unclear | Acute |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trials-based analysis Perspective: Third-party payer Time horizon: Lifetime Discount rate: Not reported |
Costs, ICERs, WTP | Bootstrap analysis | Long-term survival |
| Cleland et al. [56] multi-country | Unclear | Mixed |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trials-based analysis Perspective: Third-party payer Time horizon: 4 years Discount rate: 3% for both costs and health outcomes |
LYG, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Long-term survival Hospitalization |
| Sculpher et al. [45] UK | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: NHS Time horizon: 4 years Discount rate: 6% for costs and 2% for health outcomes |
LYG, costs, ICERs, WTP | Sensitivity analysis was not specified but established key model drivers | Risk of death Hospitalization |
| Delea et al. [19] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Six-state Markov model with 1-month cycle lengths Perspective: Not reported Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
LYG, costs, ICERs | Not specified | Not reported |
| Rosen et al. [26] USA | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with 1-year cycle lengths Perspective: Payer Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
LYG, costs, ICERs, WTP | OWSA | Hazard ratios for RCA, CHF, and MI |
| Inomata et al. [66] Japan | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Four-state Markov model with 1-month cycle length Perspective: Payer Time horizon: Lifetime Discount rate: 3% for both costs and health outcomes |
LYG, costs | Not specified | Not reported |
| Gregory et al. [21] USA | Unclear | Unclear |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial- and registry-based data analyses Perspective: Not reported Time horizon: Lifetime Discount rate: 5% for both costs and health outcomes |
LYG, costs, ICERs | Sensitivity analysis was not specified but established key model drivers | Price of drug Relative mortality risk |
| Barry [72] Ireland | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Markov model Perspective: Healthcare Time horizon: 10 years Discount rate: 5% for costs and 1.5% for health outcomes |
ICERs | OWSA | Price of drug |
| Cowper et al. [58] multi-country | Unclear | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Markov model using NYHA disease classification and death to establish health states with 6-month cycle lengths Perspective: Societal, Medicare, hospital, physician, and patient Time horizon: 5 years Discount rate: 3% for both costs and health outcomes |
Costs | OWSA | Clinical efficacy of beta-blockers |
| Glick et al. [64] multi-country | NYHA | Mixed |
Core model/adaptation: Core model Study type: Cost utility Model type: Decision analytic model Perspective: Payers Time horizon: Not reported Discount rate: 3% for both costs and health outcomes |
QALYs, costs | OWSA | HF classification |
| Caro et al. [77] multi-country | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Discrete-event simulation Perspective: Payer Time horizon: 2 years Discount rate: 3% for both health costs and outcomes |
Costs | Not specified | Not reported |
| Gerhard et al. [20] USA | NYHA | Unclear |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Decision-tree model Perspective: Not reported Time horizon: 6 months Discount rate: Not reported |
LYG, costs, ICERs | Not reported | Not reported |
| Dasbach et al. [59] multi-country | NYHA | Unclear |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Trial-based analysis Perspective: Third-party payer Time horizon: Not reported Discount rate: 3% for both costs and health outcomes |
Costs, WTP | Sensitivity analysis was not specified but established key model drivers | Overall survival Resource data |
| Levy et al. [49] Canada | Unclear | Unclear |
Core model/adaptation: Adaptation Study type: Cost effectiveness Model type: 5-state Markov model with 1-month cycle lengths Perspective: Payer Time horizon: 20 years Discount rate: 3% for both costs and health outcomes |
LYG, costs, ICERs | PSA | Discount rate Choice of out-of-hospital mortality rate |
| McMurray et al. [78] NA | Unclear | Unclear |
Core model/adaptation: Not reported Study type: Cost effectiveness Model type: Survival analysis Perspective and time horizon: Not reported Discount rate: 6% for both costs and health outcomes |
LYG, costs, ICERs | Not specified | Not reported |
| Van Genugten et al. [71] Netherlands | Unclear | Unclear |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Survival analysis Perspective: Not reported Time horizon: Lifetime Discount rate: 4% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | OWSA and PSA | Not reported |
| Cowie et al. [38] UK | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost utility Model type: Markov model with 1-year cycle lengths Perspective: Payer Time horizon: Lifetime Discount rate: 4% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Not specified | Not reported |
| Tilson et al. [74] Ireland | Unclear | Unclear |
Core model/adaptation: Adaptation Study type: Cost effectiveness Model type: Markov model Perspective: Payer Time horizon: 10 years Discount rate: 5% for both costs and health outcomes |
ICERs | Not specified | Not reported |
| Kourlaba et al. [67] Greece | NYHA | Chronic |
Core model/adaptation: Adaptation Study type: Cost effectiveness Model type: Two-state, alive and dead, Markov model Perspective: Third-party payer Time horizon: Lifetime Discount rate: 3.5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | Scenario analysis | Not reported |
| Banka et al. [17] USA | NYHA | Unclear |
Core model/adaptation: Not reported Study type: Cost effectiveness Model type: Two-state, alive and dead, Markov model Perspective: Single payer and healthcare Time horizon: Lifetime Discount rate: 3.5% for both costs and health outcomes |
QALYs, LYG, costs, ICERs | Sensitivity analysis was not specified but established key model drivers | Probability of death Hospitalization Total costs Length of HF treatment’s risk reduction on mortality and hospitalization |
| Yao et al. [76] multi-country | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Markov model with 1-month cycle lengths Perspective: Payer, NHS Time horizon: Lifetime Discount rate: 4% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, VBP | Scenario analysis | Not reported |
| Griffiths et al. [40] UK | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost effectiveness Model type: Two-state Markov model, with 1-month cycle lengths Perspective: NHS Time horizon: Lifetime Discount rate: 4% for both costs and health outcomes |
QALYs, LYG, costs, ICERs, WTP | DSA and PSA | Treatment effect |
| Vera-Llonch et al. [28] USA | NYHA | Chronic |
Core model/adaptation: Core model Study type: Cost minimization Model type: Trial-based analysis Perspective, time horizon, discount rate: NA |
Costs | Not specified | Not reported |
AE adverse event, AF atrial fibrillation, AMI acute myocardial infarction, CHF chronic heart failure, CV cardiovascular, DSA deterministic sensitivity analysis, ED emergency department, HF heart failure, ICER incremental cost-effectiveness ratio, LYG life-years gained, MI myocardial infarction, NA not applicable, NHS National Health Service, NYHA New York Heart Association, OWSA one-way sensitivity analysis, PSA probabilistic sensitivity analysis, QALYs quality-adjusted life-years, RCA root cause analysis, VBP value-based pricing, WTP willingness to pay