Heart failure (HF) is a leading cause of mortality and morbidity across the globe. High prevalence, frequent hospitalization, longterm healthcare, absenteeism from work, and death upsurge the economic burden of the HF. For almost two decades, the angiotensin converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and beta-blockers (BBs) have remained the standard care of management for HF. But despite being efficacious and cost-effective theses standard treatment were unable reduce events of rehospitalization and improve quality of life for patients with HF. Recent innovative discovery of angiotensin receptor/neprilysin inhibitor (ARNI) therapy changed the entire outlook for management of HF. Sacubitril/Valsartan an ARNI proved out to be a revolutionary drug for patients of HF. Compared to other drug classes, Sacubitril/Valsartan combination therapy is more efficacious, have lesser adverse effect, and improves overall quality of life of HF patients with reduced ejection fraction. However, the cost-effectiveness of Sacubitril/Valsartan remained questionable in developing parts of world. At the current pricing Sacubitril/Valsartan was found to be cost-effective only at specific threshold of willingness to pay of the patients. Better Federal healthcare policies, new-pricing strategies, robust long-term real-world estimates of this drug are required to improve the cost-effective profile of this drug.