Financial impact of ivabradine on reducing heart failure penalties under the Hospital Readmission Reduction Program

Abstract

Objective: The introduction of the Hospital Readmission Reduction Program (HRRP) has led to renewed interest in developing strategies to reduce 30 day readmissions among patients with heart failure (HF). In this study, a model was developed to investigate whether the addition of ivabradine to a standard-of-care (SoC) treatment regimen for patients with HF would reduce HRRP penalties incurred by a hypothetical hospital with excess 30 day readmissions.

Research design: A model using a Monte Carlo simulation framework was developed. Model inputs included national hospital characteristics, hospital-specific characteristics, and the ivabradine treatment effect as quantified by a post hoc analysis of the Systolic Heart failure treatment with the I_f inhibitor ivabradine Trial (SHIFT).

Results: The model computed an 83% reduction in HF readmission penalty payments in a hypothetical hospital with a readmission rate of 22.95% (excess readmission ratio = 1.056 over the national average readmission rate of 21.73%), translating into net savings of $44,016. A sensitivity analysis indicated that the readmission penalty is affected by the specific characteristics of the hospital, including the readmission rate, size of the ivabradine-eligible population, and ivabradine utilization.

Conclusions: The results of this study indicate that the addition of ivabradine to an SoC treatment regimen for patients with HF may lead to a reduction in the penalties incurred by hospitals under the HRRP. This highlights the role ivabradine can play as part of a wider effort to optimize the care of patients with HF.

Keywords:

• Heart failure
• hospital readmission reduction program (HRRP)
• ivabradine
• readmission penalties
• readmissions

Note

Transparency

Declaration of funding

Funding for the SHIFT study was provided by Servier Inc., and funding for this analysis was provided by Amgen Inc.

Declaration of financial/other relationships

J.S.B. has disclosed that he has received scientific support, consulting fees, and/or speaker honoraria from Servier and Amgen Inc., and consulting fees from Celladon, Pfizer, ARMGO, Cardiorentis, Novartis, AstraZeneca, and Takeda USA. M.B., I.F., and M.K. have disclosed that they have received scientific support, consulting fees, and/or speaker honoraria from Servier and Amgen Inc. A.R.K., S.K., and A.T. have disclosed that they are employees of Evidera. H.K.P., A.K., and J.M. have disclosed that they are employees of and stockholders in Amgen Inc. L.T. has received scientific support and speaking and consulting fees from Servier and Amgen Inc.

CMRO peer reviewer 1 has disclosed that he has received grants from the Medical Research Council, UK; peer reviewer 2 has no relevant financial or other relationships to disclose.

Acknowledgments

Editorial support was provided by Janice Carlson PhD of Amgen Inc. and Shobana Ganesan MSc, CACTUS Communications, on behalf of Amgen Inc.

Notes

1 Corlanor is a registered trade name of Amgen Inc., Thousand Oaks, CA, USA