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Cost-effectiveness of dapagliflozin for patients with heart failure across the spectrum of ejection fraction: A pooled analysis of DAPA-HF and DELIVER data.
- Source :
-
European journal of heart failure [Eur J Heart Fail] 2024 Mar; Vol. 26 (3), pp. 664-673. Date of Electronic Publication: 2024 Mar 20. - Publication Year :
- 2024
-
Abstract
- Aim: To assess the cost-effectiveness of dapagliflozin in addition to usual care, compared with usual care alone, in a large population of patients with heart failure (HF), spanning the full range of left ventricular ejection fraction (LVEF).<br />Methods and Results: Patient-level data were pooled from HF trials (DAPA-HF, DELIVER) to generate a population including HF with reduced, mildly reduced and preserved LVEF, to increase statistical power and enable exploration of interactions among LVEF, renal function and N-terminal pro-B-type natriuretic peptide levels, as they are relevant determinants of health status in this population. Survival and HF recurrent event risk equations were derived and applied to a lifetime horizon Markov model with health states defined by Kansas City Cardiomyopathy Questionnaire total symptom score quartiles; costs and utilities were in the UK setting. The base case incremental cost-effectiveness ratio (ICER) was £6470 per quality-adjusted life year (QALY) gained, well below the UK willingness-to-pay (WTP) threshold of £20 000/QALY gained. In interaction sensitivity analyses, the highest ICER was observed for elderly patients with preserved LVEF (£16 624/QALY gained), and ranged to a region of dominance (increased QALYs, decreased costs) for patients with poorer renal function and reduced/mildly reduced LVEF. Results across the patient characteristic interaction plane were mostly between £5000 and £10 000/QALY gained.<br />Conclusions: Dapagliflozin plus usual care, versus usual care alone, yielded results well below the WTP threshold for the UK across a heterogeneous population of patients with HF including the full spectrum of LVEF, and is likely a cost-effective intervention.<br /> (© 2024 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
- Subjects :
- Humans
Male
Female
Aged
Middle Aged
Sodium-Glucose Transporter 2 Inhibitors therapeutic use
Sodium-Glucose Transporter 2 Inhibitors economics
Benzhydryl Compounds therapeutic use
Benzhydryl Compounds economics
Heart Failure drug therapy
Heart Failure physiopathology
Heart Failure economics
Cost-Benefit Analysis
Stroke Volume physiology
Glucosides therapeutic use
Glucosides economics
Quality-Adjusted Life Years
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0844
- Volume :
- 26
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- European journal of heart failure
- Publication Type :
- Academic Journal
- Accession number :
- 38509642
- Full Text :
- https://doi.org/10.1002/ejhf.3197