Alternative payment models and innovation: a case study of US health system adoption of a sacubitril/valsartan to treat acute decompensated heart failure
| Autor: | Xian Shen, Michelle Brauer, Jason Shafrin, Elmar R. Aliyev, Siyeon Park |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute decompensated heart failure Angiotensin-Converting Enzyme Inhibitors Medicare 03 medical and health sciences Angiotensin Receptor Antagonists 0302 clinical medicine Payment models medicine Humans Intensive care medicine Aged Heart Failure Financial impact business.industry 030503 health policy & services Health Policy Aminobutyrates Biphenyl Compounds medicine.disease United States Drug Combinations 030220 oncology & carcinogenesis Heart failure Valsartan Angiotensin Receptor Blockers 0305 other medical science business Sacubitril Valsartan Decision tree model Healthcare system |
| Zdroj: | Journal of medical economics. 23(12) |
| ISSN: | 1941-837X |
| Popis: | To understand the financial impact of health system adoption of novel heart failure medications under US alternative payment models (APMs).This study used a decision tree model to assess the financial impact of health system adoption of sacubitril/valsartan to treat acute decompensated heart failure (ADHF). A comparator scenario modeled current health care utilization and cost for treating hospitalized ADHF patients with angiotensin-converting-enzyme inhibitors (ACEi) or angiotensin-receptor blockers (ARB). The study then measured the impact of adopting sacubitril/valsartan to treat ADHF on health system economic outcomes. Differences in treatment efficacy were based on the PIONEER-HF clinical trial. The financial impact of changes in patient outcomes under the sacubitril/valsartan and ACEi/ARB arms was assessed across three APMs: the Medicare Shared Savings Program, Bundled Payments for Care Improvement, and fee-for-service payments adjusted according to the Hospital Readmission Reduction Program.Sacubitril/valsartan reduced re-hospitalizations after an initial ADHF admission by 46.3% for individuals aged 18The model uses clinical trial data, which may not reflect real-world outcomes. Further, the financial implications were modeled based only on three widely used APMs.Sacubitril/valsartan adoption decreased hospitalizations and led to a positive net financial impact on health systems after accounting for APM bonus payments. |
| Databáze: | OpenAIRE |
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