OBJECTIVES: To estimate the impact of including vericiguat into the Colombian health system on the burden of disease of HFrEF and worsening HF event (WHF).

METHODS: We performed an estimation of disability adjusted life years (DALY) attributable to heart failure (HF) with focus on patients with HFrEF and WHF. Years of life lost (YLL) were calculated considering premature mortality. Years lost to disability (YLD) were estimated considering disutility of HF states based on left ventricular ejection fraction. We considered direct and indirect costs (2020, 1 USD = $3,693.36 COP) using micro-costing and literature data. Subsequently, we estimated the impact of vericiguat on the burden of disease and costs considering its effects on overall mortality and hospitalizations based on results of VICTORIA study. We performed a sensitivity analysis (SA)

RESULTS: We estimated 27,061 YLD and 453,228 YLL, for a total of 480,289 DALY (226,450 DALY in patients with HFrEF and WHF). Total cost of 1.2 billion USD for all patients with HF, where costs of patients with HFrEF and WHF accounts for 46% of total costs. Around 61% were direct costs, 38.4% were lost productivity and 0,6% were out of pocket expense (0.6%). We estimated that vericiguat could reduce 665 deaths (-5.3%), 10,933 YLL (-5.2%) and -5,1% in total DALY in patients with indication HFrEF and WHF. We estimated budget variations of -9% in hospitalization costs and +5.3% for total cost (-3.8% to +12.4% in the SA) . When considering a population with 3 or more hospitalizations, vericiguat produced budget variation of -0.2% in total costs (-8.4% to +7.3% in the SA)

CONCLUSIONS: Vericiguat has a positive impact on clinical benefit for HFrEF and WHF patients. In patient subgroups where hospitalization is high (3 or more re-hospitalizations) health care system savings are generated