Cost-effectiveness of aficamten for obstructive hypertrophic cardiomyopathy: a model-based analysis from the perspective of the Chinese healthcare system.
- 1Department of Pharmacy, Anhui Wannan Rehabilitation Hospital (Wuhu Fifth People's Hospital), Wuhu, Anhui, China.
- 2Department of Pharmacy, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
- 3School of Pharmacy, Fujian Medical University, Fuzhou, Fujian, China.
Abstract
Background
To evaluate the cost-effectiveness of aficamten plus standard of care (SoC) versus SoC alone for patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) from the perspective of the Chinese healthcare system.Methods
A four-state Markov model based on the phase III SEQUOIA-HCM trial was developed to simulate lifetime outcomes. The first 24 weeks were modeled using trial data, followed by 4-week cycles for long-term extrapolation. Based on FOREST-HCM, the incremental treatment effect of aficamten was assumed to persist through week 96 and then linearly wane to complete loss by year 3. Costs and health outcomes were discounted at 4.5% annually. Model uncertainty was assessed using one-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analyses.Results
Total costs were US$143,281.22 with aficamten plus SoC and US$96,509.03 with SoC alone, with 9.696 and 7.643 QALYs, respectively. Aficamten plus SoC yielded an incremental cost of US$46,772.19 and 2.054 QALYs, corresponding to an ICER of US$22,775.17/QALY, below the WTP threshold of US$29,399.70/QALY. The probability of being cost-effective was 76.6% at the WTP threshold. Scenario analyses showed ICERs of US$19,351.77/QALY when only short-term effects were considered, US$43,752.42/QALY when treatment effects disappeared in year 5, and US$81,220.72/QALY when they disappeared in year 10. Price reductions of 22.0% and 50.5%, respectively, were required in the latter two scenarios. With a permanent discontinuation probability of 0.131% per 4-week cycle, the ICER was US$23,888.94/QALY.Conclusion
From the Chinese healthcare system perspective, aficamten plus SoC was cost-effective versus SoC alone for symptomatic oHCM under the base-case assumptions.
Related
- Clinical effectiveness of mavacamten on cardiac function and disease-related indicators in patients with obstructive hypertrophic cardiomyopathy
- Managing a mavacamten non-responder in obstructive hypertrophic cardiomyopathy: A case report
- Percutaneous endomyocardial ablation as a septal reduction strategy in symptomatic obstructive hypertrophic cardiomyopathy: A 20-year single-center observational experience.
- Hypertrophic obstructive cardiomyopathy complicated by severe midventricular obstruction treated with percutaneous transluminal septal myocardial ablation using simultaneous contrast imaging with left ventriculography and coronary angiography: a case report
- GLP-1 Receptor Agonist Use and Long-Term Outcomes in Hypertrophic Cardiomyopathy With Obstructive Sleep Apnea
BibTeX
@article{zhai2026costeffectiveness,
title = {{Cost-effectiveness of aficamten for obstructive hypertrophic cardiomyopathy: a model-based analysis from the perspective of the Chinese healthcare system.}},
author = {Feng Zhai and Hongyang Li and Chaolan Jiang and Jianpeng Mao and Jingjing Chen and Caicong You},
journal = {Frontiers in pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1938259},
url = {https://europepmc.org/article/MED/42908723},
note = {CC BY},
}
RIS
TY - JOUR
TI - Cost-effectiveness of aficamten for obstructive hypertrophic cardiomyopathy: a model-based analysis from the perspective of the Chinese healthcare system.
AU - Feng Zhai
AU - Hongyang Li
AU - Chaolan Jiang
AU - Jianpeng Mao
AU - Jingjing Chen
AU - Caicong You
PY - 2026
DA - 2026/10/07
JO - Frontiers in pharmacology
DO - 10.3389/fphar.2026.1938259
UR - https://europepmc.org/article/MED/42908723
AB - Background To evaluate the cost-effectiveness of aficamten plus standard of care (SoC) versus SoC alone for patients with symptomatic obstructive hypertrophic cardiomyopathy (oHCM) from the perspective of the Chinese healthcare system.Methods A four-state Markov model based on the phase III SEQUOIA-HCM trial was developed to simulate lifetime outcomes. The first 24 weeks were modeled using trial data, followed by 4-week cycles for long-term extrapolation. Based on FOREST-HCM, the incremental treatment effect of aficamten was assumed to persist through week 96 and then linearly wane to complete loss by year 3. Costs and health outcomes were discounted at 4.5% annually. Model uncertainty was assessed using one-way sensitivity analysis, probabilistic sensitivity analysis, and scenario analyses.Results Total costs were US$143,281.22 with aficamten plus SoC and US$96,509.03 with SoC alone, with 9.696 and 7.643 QALYs, respectively. Aficamten plus SoC yielded an incremental cost of US$46,772.19 and 2.054 QALYs, corresponding to an ICER of US$22,775.17/QALY, below the WTP threshold of US$29,399.70/QALY. The probability of being cost-effective was 76.6% at the WTP threshold. Scenario analyses showed ICERs of US$19,351.77/QALY when only short-term effects were considered, US$43,752.42/QALY when treatment effects disappeared in year 5, and US$81,220.72/QALY when they disappeared in year 10. Price reductions of 22.0% and 50.5%, respectively, were required in the latter two scenarios. With a permanent discontinuation probability of 0.131% per 4-week cycle, the ICER was US$23,888.94/QALY.Conclusion From the Chinese healthcare system perspective, aficamten plus SoC was cost-effective versus SoC alone for symptomatic oHCM under the base-case assumptions.
SN - 1663-9812
ER -