title: Financial impact of ivabradine on reducing heart failure penalties under the Hospital Readmission Reduction Program.
abstract: 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.
  
  
  
  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 Ifinhibitor ivabradine Trial (SHIFT).
  
  
  
  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.
  
  
  
  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.
authors.affiliation: a Evidera , Bethesda , MD , USA.
authors.forename: Anuraag R
authors.initials: AR
authors.lastname: Kansal
authors.affiliation: a Evidera , Bethesda , MD , USA.
authors.forename: Stanimira
authors.initials: S
authors.lastname: Krotneva
authors.affiliation: a Evidera , Bethesda , MD , USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Tafazzoli
authors.affiliation: b Amgen Inc. , Thousand Oaks , CA , USA.
authors.forename: Harshali K
authors.initials: HK
authors.lastname: Patel
authors.affiliation: c Division of Cardiovascular Medicine , The Howard Gilman Institute for Heart Valve Diseases and Ronald and Joan Schiavone Cardiovascular Translational Research Institute, State University of New York Downstate Medical Center , Brooklyn and New York , NY , USA.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Borer
authors.affiliation: d Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes , Homburg/Saar , Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.affiliation: e Department of Cardiology , Pitié-Salpétrière Hospital, University Pierre et Marie Curie and IHU ICAN , Paris , France.
authors.forename: Michel
authors.initials: M
authors.lastname: Komajda
authors.affiliation: b Amgen Inc. , Thousand Oaks , CA , USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Maya
authors.affiliation: f Maria Cecilia Hospital, GVM Care & Research, Ettore Sansavini Health Science Foundation , Cotignola , Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
authors.affiliation: g Robertson Centre for Biostatistics, University of Glasgow , Glasgow , Scotland.
authors.forename: Ian
authors.initials: I
authors.lastname: Ford
authors.affiliation: b Amgen Inc. , Thousand Oaks , CA , USA.
authors.forename: Adrian
authors.initials: A
authors.lastname: Kielhorn
mesh_terms: D001552:Benzazepines / Q000008:administration & dosage*; D006333:Heart Failure / Q000188:drug therapy* / Q000453:epidemiology; D054143:Heart Failure, Systolic / Q000188:drug therapy; D006761:Hospitals; D006801:Humans; D000077550:Ivabradine; D010359:Patient Readmission / Q000191:economics
chemical_list: D001552:Benzazepines; D000077550:Ivabradine
keywords: Heart failure; hospital readmission reduction program (HRRP); ivabradine; readmission penalties; readmissions