{"id":"62f7193f44e4","type":"article","url":"https://hartvaat.nl/2026/08/18/tafamidis-bij-attr-cardiomyopathie-kosteffectiviteit-onder-de-maat-in-vier-europ/","title":"Tafamidis bij ATTR-cardiomyopathie kosteffectiviteit onder de maat in vier Europese landen","title_en":"Deterministic Economic Modelling Study of Tafamidis in Transthyretin Amyloid Cardiomyopathy Across Four European Healthcare Systems.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog"],"tags":[],"journal":"European heart journal. Quality of care & clinical outcomes","doi":"10.1093/ehjqcco/qcag129","source_url":"https://doi.org/10.1093/ehjqcco/qcag129","authors":["Kossar Hosseini","Nicolas Girerd","François Roubille","Luca Monzo","Guillaume Baudry","Jonathan Epstein","Francis Guillemin","Jean-Marc Boivin"],"significance":4,"published":"2026-08-26","source_date":"2026-08-18","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/palliatief-hartfalen/","https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"A deterministic modelling study indicates that tafamidis for transthyretin amyloid cardiomyopathy (ATTR-CM) is unlikely to be cost-effective in France, Spain, Germany, and the UK against a €100,000/QALY threshold. Incremental cost-effectiveness ratios ranged from €398,136 to €1,398,706 per QALY, with sensitivity analyses showing less than 13% probability of meeting the acceptability threshold. While tafamidis improves survival and quality of life in ATTR-CM, these findings raise significant concerns regarding the funding and accessibility of this high-cost therapy across European healthcare systems.","created":"2026-08-19T01:22:20Z","updated":"2026-08-19T01:22:20Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een deterministisch modelleeronderzoek toont aan dat tafamidis voor transthyretine-amyloïdose-cardiomyopathie (ATTR-CM) in Frankrijk, Spanje, Duitsland en het VK waarschijnlijk niet kosteffectief is volgens de Europese drempel van €100.000 per QALY. De ICER's lagen tussen de €398.000 en €1,4 miljoen per QALY, met een zeer lage kans (<13%) dat het middel onder de acceptatiegrens zou vallen. Hoewel tafamidis de overleving en levenskwaliteit bij ATTR-CM verbetert, roept deze economische analyse vragen op over de financiering en toegankelijkheid van deze dure therapie in de Europese zorgsystemen.","abstract_original":"INTRODUCTION: Tafamidis has been demonstrated to improve survival and quality of life in transthyretin amyloid cardiomyopathy (ATTR-CM). However, its cost-effectiveness has been reported to exceed the threshold of $100,000/quality-adjusted life years [QALY] in the US healthcare system. This study aimed to evaluate costs associated with utilities (QALYs) gained for ATTR-CM in France, Spain, Germany, and the United Kingdom (UK), and to conduct a deterministic modelling study using case-scenarii based on various assumptions at a European level. METHODS: Data on costs and QALY were extracted using MEDLINE. The lack of data on the cost of the cardiac amyloidosis in patients treated with tafamidis led us to modelling our study based on heart failure assumptions. We used QALY gained in the tafamidis group as reported for ATTR-CM patients in the ATTR-ACT trial to determine the incremental cost-effectiveness ratio (ICER) of tafamidis compared with standard care. A sensitivity analysis was conducted with assumptions on costs and QALYs gained. RESULTS: Incremental cost-effectiveness ratios (ICER) for each country largely exceeded the threshold of €100,000/QALY, ranging from €398,136/QALY gained in France to €1,398,706/QALY gained in Germany. The sensitivity analysis revealed large variations of the ICER, with only 27.4%, 0.2%, 13% and 9% probability of cases below the acceptability threshold of €100,000/QALY in France, Spain, Germany and UK, respectively. CONCLUSION: While tafamidis offers a significant improvement in patients' quality of life and survival, these exploratory scenario-based estimates showing high cost-effectiveness ratio in some European countries, may raise public health and cost management concerns."}