However, a recent economic evaluation using participant-level data from the PARADIGM-HF and PARAGON-HF trials (n = 13,264) found sacubitril–valsartan to be more cost-effective at lower EF ranges with a high economic value for patients with HFrEF or HFmEF (EF ≤ 50%) and at least of intermediate value to an EF ≤ 60% compared with renin–angiotensin system inhibitors. The gene discussed is REN; the disease is hydrops fetalis.