{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:25:06Z","timestamp":1790400306201,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,5,7]]},"abstract":"\n Background<\/jats:title>\n \n Outcomes data among patients with heart failure (HF) with reduced ejection fraction treated with sacubitril\/valsartan (\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n ) are largely limited to clinical trial results. We compared hospitalization and healthcare costs among real\u2010world patients with HF with reduced ejection fraction treated with\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n versus angiotensin\u2010converting enzyme inhibitor or angiotensin\u2010receptor blocker (\n ACEI<\/jats:styled-content>\n \/\n ARB<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Using retrospective administrative claims data, stable patients with HF with reduced ejection fraction treated with\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n or\n ACEI<\/jats:styled-content>\n \/\n ARB<\/jats:styled-content>\n from October 2015 to June 2016 were identified. Postindex hospitalization and healthcare costs were assessed in propensity\u2010matched cohorts using robust variance estimation. Time to first hospitalization was modeled using unadjusted Kaplan\u2013Meier estimates and multivariable models. Postindex all\u2010cause healthcare costs were modeled using an adjusted multivariable model. Among 279 patients per matched cohort, postindex hospitalization risk was lower for\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n compared with\n ACEI<\/jats:styled-content>\n \/\n ARB<\/jats:styled-content>\n using Kaplan\u2013Meier estimation and unadjusted Cox models. For\n HF<\/jats:styled-content>\n hospitalization, the hazard ratio (95% CI) was 0.56 (0.33\u20130.94;\n P<\/jats:italic>\n =0.030). Adjusted results were similar to unadjusted. Mean (\n SD<\/jats:styled-content>\n ) monthly healthcare costs were lower for\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n versus\n ACEI<\/jats:styled-content>\n \/\n ARB<\/jats:styled-content>\n for all categories except pharmacy, with hospital costs being particularly disparate between cohorts: for\n HF<\/jats:styled-content>\n hospitalization, $248 ($1588) for\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n versus $1122 ($7290) for\n ACEI<\/jats:styled-content>\n \/\n ARB<\/jats:styled-content>\n . The adjusted risk of incurring increased all\u2010cause postindex costs was lower for\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n versus\n ACEI<\/jats:styled-content>\n \/\n ARB<\/jats:styled-content>\n (cost ratio [95% CI] 0.74 [0.59\u20130.94];\n P<\/jats:italic>\n =0.013).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In clinical practice, patients with HF with reduced ejection fraction treated with\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n were less likely to be hospitalized than matched patients treated with\n ACEI<\/jats:styled-content>\n \/\n ARB<\/jats:styled-content>\n . Despite higher pharmacy costs,\n SAC<\/jats:styled-content>\n \/\n VAL<\/jats:styled-content>\n \u2013treated patients incurred lower monthly medical and total healthcare costs.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011089","type":"journal-article","created":{"date-parts":[[2019,4,26]],"date-time":"2019-04-26T09:00:33Z","timestamp":1556269233000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Lower Hospitalization and Healthcare Costs With Sacubitril\/Valsartan Versus Angiotensin\u2010Converting Enzyme Inhibitor or Angiotensin\u2010Receptor Blocker in a Retrospective Analysis of Patients With Heart Failure"],"prefix":"10.1161","volume":"8","author":[{"given":"Nancy M.","family":"Albert","sequence":"first","affiliation":[{"name":"Cleveland Clinic Cleveland OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P.","family":"Swindle","sequence":"additional","affiliation":[{"name":"Optum Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin K.","family":"Buysman","sequence":"additional","affiliation":[{"name":"Optum Eden Prairie MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunlan","family":"Chang","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals Corporation East Hanover NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000558"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/HHF.0b013e318291329a"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcad.2017.08.006"},{"key":"e_1_3_2_5_2","first-page":"e282","article-title":"2016 ACC\/AHA\/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America","volume":"134","author":"Yancy CW","year":"2016","unstructured":"Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE Jr, Colvin MM, Drazner MH, Filippatos G, Fonarow GC, Givertz MM, Hollenberg SM, Lindenfeld J, Masoudi FA, McBride PE, Peterson PN, Stevenson LW, Westlake C. 2016 ACC\/AHA\/HFSA focused update on new pharmacological therapy for heart failure: an update of the 2013 ACCF\/AHA guideline for the management of heart failure: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. 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Available at: https:\/\/www.bls.gov\/cpi\/data.htm. Accessed June 15 2017."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-018-0710-4"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/phar.1701"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2147\/RMHP.S130341"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.117.004302"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.009237"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018622"},{"key":"e_1_3_2_20_2","first-page":"13","article-title":"Heart failure due to reduced ejection fraction: medical management","volume":"95","author":"Chavey WE","year":"2017","unstructured":"Chavey WE, Hogikyan RV, Van Harrison R, Nicklas JM. Heart failure due to reduced ejection fraction: medical management. 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