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Cost-effectiveness evaluation of add-on dapagliflozin for heart failure with reduced ejection fraction from perspective of healthcare systems in Asia-Pacific region.
- Source :
-
Cardiovascular diabetology [Cardiovasc Diabetol] 2021 Oct 09; Vol. 20 (1), pp. 204. Date of Electronic Publication: 2021 Oct 09. - Publication Year :
- 2021
-
Abstract
- Background: With emerging evidence on the efficacy of adding dapagliflozin to standard care for patients with heart failure with reduced ejection fraction (HFrEF), this study assessed the cost-effectiveness of add-on dapagliflozin to standard care versus standard care alone for HFrEF from the perspective of healthcare systems in the Asia-Pacific region.<br />Methods: A Markov model was applied to project the outcomes of treatment in terms of lifetime medical cost and quality-adjusted life-years. The transition probabilities between health states in the model were obtained from the Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction trial. Country-specific costs and utilities were extracted for modeling. The incremental cost-effectiveness ratio against a country-specific willingness-to-pay threshold was applied to determine the cost-effectiveness of treatment. A series of sensitivity analyses were performed to ensure the robustness of the study results. Costs are presented in 2020 United States dollars.<br />Results: The incremental cost-effectiveness ratios for add-on dapagliflozin versus standard care alone were $5277, $9980, $12,305, $16,705, and $23,227 per quality-adjusted life-year gained in Korea, Australia, Taiwan, Japan, and Singapore, respectively. When using add-on dapagliflozin to standard care versus standard care alone, ~ 100% of simulations were cost-effective at a willingness-to-pay threshold of one gross domestic product per capita of the given Asia-Pacific country; however, the probability of being cost-effective for using add-on dapagliflozin decreased when the time horizon for simulation was restricted to 18 months and when the cardiovascular mortality for the two treatments (43.8% and 33.0%, respectively) was assumed to be the same. The cost-effectiveness results were most sensitive to cardiovascular mortality of treatment.<br />Conclusions: Adding dapagliflozin to standard care is cost-effective for HFrEF in healthcare systems in the Asia-Pacific region, which supports the rational use of dapagliflozin for HFrEF in this region.<br /> (© 2021. The Author(s).)
- Subjects :
- Aged
Asia epidemiology
Australia epidemiology
Benzhydryl Compounds adverse effects
Cost-Benefit Analysis
Female
Glucosides adverse effects
Heart Failure, Systolic mortality
Heart Failure, Systolic physiopathology
Hospital Costs
Hospitalization economics
Humans
Male
Markov Chains
Models, Economic
Quality of Life
Quality-Adjusted Life Years
Recovery of Function
Sodium-Glucose Transporter 2 Inhibitors adverse effects
Sodium-Glucose Transporter 2 Inhibitors economics
Time Factors
Treatment Outcome
Benzhydryl Compounds economics
Benzhydryl Compounds therapeutic use
Delivery of Health Care economics
Drug Costs
Glucosides economics
Glucosides therapeutic use
Heart Failure, Systolic drug therapy
Heart Failure, Systolic economics
Sodium-Glucose Transporter 2 Inhibitors therapeutic use
Stroke Volume drug effects
Ventricular Function, Left drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1475-2840
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular diabetology
- Publication Type :
- Academic Journal
- Accession number :
- 34627231
- Full Text :
- https://doi.org/10.1186/s12933-021-01387-3