Net health benefit of mavacamten for the treatment of Chinese patients with obstructive hypertrophic cardiomyopathy: a model-based economic evaluation

TL;DR

This study shows that mavacamten improves survival and quality of life for Chinese patients with obstructive heart disease compared to standard treatments.

Contribution

The study evaluates the health benefits of mavacamten in Chinese patients with obstructive hypertrophic cardiomyopathy using a model-based economic evaluation.

Findings

Mavacamten ± BB/CCBs showed better health outcomes with 15.76 life-years versus 14.40 with BB/CCB monotherapy.

Quality-adjusted life-years (QALYs) were higher with mavacamten (13.69 vs. 11.38).

Mavacamten provides clinically meaningful improvements in survival and quality of life for obstructive HCM patients.

Abstract

Obstructive hypertrophic cardiomyopathy (HCM) is a cardiovascular disorder characterized by significant symptom burden. This study aims to evaluate the net clinical benefit of mavacamten (a first-in-class cardiac myosin inhibitor) ± beta-blockers/calcium channel blockers (BB/CCBs) compared to BB/CCB monotherapy for Chinese patients with obstructive HCM.

A five-state Markov model (NYHA classes I–IV and death) was developed from a Chinese healthcare system perspective. Patients were initialised in NYHA II or III states, mirroring the baseline distribution in the EXPLORER-CN trial (NCT05174416). State transitions were simulated using cycle-specific probabilities derived from trial data and validated extrapolation assumptions. All-cause mortality risks incorporated disease-specific and extra surgical mortality rates. Treatment sequencing rules reflected escalation pathways (e.g., non-response, adverse events, or eligibility for septural reduction therapy [SRT]), informed by Chinese clinical practice. Health utilities were mapped algorithmically from EXPLORER-CN patient-level EQ-5D responses.

Over a lifetime horizon, mavacamten ± BB/CCBs demonstrated superior health outcomes versus BB/CCB monotherapy, with incremental gains in life-years (15.76 vs. 14.40) and quality-adjusted life-years (QALYs: 13.69 vs. 11.38).

Mavacamten provides substantial health benefits for Chinese obstructive HCM patients, including clinically meaningful improvements in survival and quality-of-life metrics relative to standard care.

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