Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction

© 2020 Elsevier B.V. Background: Dapagliflozin is an antidiabetic medication that has been shown to reduce the risk of heart failure hospitalization and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to determine the cost-utility of add-o...

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Main Authors: Rungroj Krittayaphong, Unchalee Permsuwan
Format: Journal
Published: 2020
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/70945
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spelling th-cmuir.6653943832-709452020-10-14T08:45:24Z Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction Rungroj Krittayaphong Unchalee Permsuwan Medicine © 2020 Elsevier B.V. Background: Dapagliflozin is an antidiabetic medication that has been shown to reduce the risk of heart failure hospitalization and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to determine the cost-utility of add-on dapagliflozin treatment for HFrEF. Methods: An analytical decision model was constructed to assess lifetime costs and outcomes from a healthcare system perspective. The cohort comprised HFrEF patients with left ventricular ejection fraction (LVEF) ≤40%, and New York Heart Association (NYHA) class II–IV with an average age of 65 years. Clinical inputs were derived from the results of the Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure (DAPA-HF) trial. Risk of non-cardiovascular death data, readmission rate data, and treatment-related cost data were based on Thai population. The outcomes and costs were discounted at 3% annually. A series of sensitivity analyses were also conducted. Results: The increased cost of dapagliflozin add-on treatment from 17,442 THB (559 USD) to 54,405 THB (1745 USD) was associated with a QALY gain from 6.33 to 6.92 compared to standard therapy, yielding an ICER of 62,090 THB/QALY (1991 USD/QALY). Sensitivity analyses revealed that the addition of dapagliflozin to the standard treatment demonstrated an 87% cost-effectiveness strategy at a level of willingness to pay (WTP) of 160,000 THB/QALY (5131 USD/QALY). ICER was higher in non-diabetes compared to diabetes (68,304 vs 47,613 THB/QALY or 2191 vs 1527 USD/QALY). Conclusions: Dapagliflozin is a cost-effective add-on therapy for patients with HFrEF at a WTP of 160,000 THB/QALY (5131 USD/QALY). 2020-10-14T08:45:24Z 2020-10-14T08:45:24Z 2020-01-01 Journal 18741754 01675273 2-s2.0-85089826614 10.1016/j.ijcard.2020.08.017 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85089826614&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/70945
institution Chiang Mai University
building Chiang Mai University Library
continent Asia
country Thailand
Thailand
content_provider Chiang Mai University Library
collection CMU Intellectual Repository
topic Medicine
spellingShingle Medicine
Rungroj Krittayaphong
Unchalee Permsuwan
Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction
description © 2020 Elsevier B.V. Background: Dapagliflozin is an antidiabetic medication that has been shown to reduce the risk of heart failure hospitalization and cardiovascular death in patients with heart failure with reduced ejection fraction (HFrEF). This study aimed to determine the cost-utility of add-on dapagliflozin treatment for HFrEF. Methods: An analytical decision model was constructed to assess lifetime costs and outcomes from a healthcare system perspective. The cohort comprised HFrEF patients with left ventricular ejection fraction (LVEF) ≤40%, and New York Heart Association (NYHA) class II–IV with an average age of 65 years. Clinical inputs were derived from the results of the Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure (DAPA-HF) trial. Risk of non-cardiovascular death data, readmission rate data, and treatment-related cost data were based on Thai population. The outcomes and costs were discounted at 3% annually. A series of sensitivity analyses were also conducted. Results: The increased cost of dapagliflozin add-on treatment from 17,442 THB (559 USD) to 54,405 THB (1745 USD) was associated with a QALY gain from 6.33 to 6.92 compared to standard therapy, yielding an ICER of 62,090 THB/QALY (1991 USD/QALY). Sensitivity analyses revealed that the addition of dapagliflozin to the standard treatment demonstrated an 87% cost-effectiveness strategy at a level of willingness to pay (WTP) of 160,000 THB/QALY (5131 USD/QALY). ICER was higher in non-diabetes compared to diabetes (68,304 vs 47,613 THB/QALY or 2191 vs 1527 USD/QALY). Conclusions: Dapagliflozin is a cost-effective add-on therapy for patients with HFrEF at a WTP of 160,000 THB/QALY (5131 USD/QALY).
format Journal
author Rungroj Krittayaphong
Unchalee Permsuwan
author_facet Rungroj Krittayaphong
Unchalee Permsuwan
author_sort Rungroj Krittayaphong
title Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction
title_short Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction
title_full Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction
title_fullStr Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction
title_full_unstemmed Cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction
title_sort cost-utility analysis of add-on dapagliflozin treatment in heart failure with reduced ejection fraction
publishDate 2020
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85089826614&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/70945
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