Key result
Empagliflozin and dapagliflozin prove cost-effective for HFpEF in China, with empagliflozin at ~$3,692 per QALY.
Why the study?
Although clinical benefits of empagliflozin and dapagliflozin in HFpEF were demonstrated in clinical trials, their cost-effectiveness was yet to be established.
Are empagliflozin or dapagliflozin cost-effective compared to standard care for patients with HFpEF in China?
Are empagliflozin or dapagliflozin cost-effective compared to standard care for patients with HFpEF in China?
Both empagliflozin and dapagliflozin are projected to be cost-effective treatments for patients with HFpEF within the Chinese healthcare system.
Background: The potential benefits of intervention with empagliflozin or dapagliflozin for patients with heart failure with preserved ejection fraction (HFpEF) were first demonstrated in the EMPEROR-Preserved and DELIVER studies. However, the cost-effectiveness of this intervention (empagliflozin or dapagliflozin) is yet to be established. Methods: In the context of Chinese healthcare, a Markov model was proposed, which incorporates clinical outcomes from the EMPEROR-Preserved and DELIVER studies, to predict the utility and costs over a lifetime. The time horizon was 20 years, and a 5% discount rate was applied to the costs and utilities. The incremental cost-effectiveness ratio (ICER) threshold against willingness to pay (WTP) was set as the primary outcome. The robustness of the decision was evaluated using sensitivity analyses. Results: After a simulated 20-year lifetime, a 72-year-old patient with HFpEF in the intervention group (empagliflozin) showed an increase of 0.44 quality-adjusted life years (QALYs) and $1,623.58 with an ICER of $3,691.56 per QALY, which was lower than the WTP threshold of $12,032.10 per QALY. A 72-year-old patient with HFpEF in the intervention group (dapagliflozin) showed an increase of 0.34 QALYs and $2,002.13 with an ICER of $5,907.79 per QALY, which was lower than the WTP threshold of $12,032.10 per QALY. One-way sensitivity analyses showed that cardiovascular (CV) mortality in the intervention and comparator groups was the most sensitive to the decision. Cost-effectiveness was demonstrated in the intervention group (empagliflozin or dapagliflozin) in 67.9% or 62.2% of 1000 Monte Carlo simulations, respectively. Conclusion: In Chinese healthcare, the interventions (empagliflozin or dapagliflozin) for HFpEF were more cost-effective than the comparators. Our study has provided a quantitative evaluation of the costs and benefits of such interventions for a lifetime using the model.
No takes yet. Share an insight, caveat, or question.
H et al. (2023) studied Heart failure with preserved ejection fraction (HFpEF) (n=103,538). Empagliflozin or Dapagliflozin vs. Placebo and standard treatment was evaluated on Incremental cost-effectiveness ratio (ICER) per QALY for empagliflozin. Empagliflozin and dapagliflozin were cost-effective for treating HFpEF in China, yielding incremental cost-effectiveness ratios of $3,691.56 and $5,907.79 per QALY, respectively.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: