Chronic heart failure (CHF) confers high mortality and heavy economic burden as a critical public health issue. Qili Qiangxin (QLQX) capsules, a traditional Chinese patent medicine, may improve clinical outcomes in CHF patients. This study evaluated the economic value of QLQX capsules for CHF.

A health economic analysis was performed from the healthcare system perspective. Cost-effectiveness analysis was used for short-term outcomes, and a Markov model-based cost-utility analysis for long-term outcomes. Robustness was tested using one-way and probabilistic sensitivity analyses.

A total of 1555 patients were equally randomized to two groups: QLQX capsules plus standard of care (QLQX group) or standard of care alone (control group). Baseline characteristics were comparable between groups. In the QLQX group, 1-year direct medical costs were ¥9368.08 ($1311.53; 95% confidence interval [CI]: [¥8980.61, ¥9755.55]), versus ¥6402.21 ($896.31; 95% CI: [¥5903.50, ¥6900.91]) in the control group. The higher costs in the QLQX group were primarily driven by medication expenses. Composite endpoint events occurred in 19.00% (95% CI: [17.07%, 21.03%]) of the QLQX group compared with 23.40% (95% CI: [21.34%, 25.61%]) of the control group (P = 0.003). The incremental cost-effectiveness ratio (ICER) was ¥67 406.14 ($9436.86). Over a 15-year time horizon, the QLQX group incurred total costs of ¥57 096 ($7993.44) and achieved 5.46 QALYs, whereas the control group incurred ¥34 016 ($4762.24) and achieved 5.07 QALYs, resulting in an ICER of ¥58 946 per QALY ($8252.44/QALY). This value is below China’s 2023 per capita gross domestic product threshold (¥89 358; $12 510.12), suggesting that QLQX capsule is highly cost-effective. Sensitivity analyses further confirmed the robustness of these findings.

QLQX capsules were associated with higher short-term costs but greater efficacy than standard care, and long-term modeling supports their high cost-effectiveness.