Key result
Empagliflozin proves cost-effective for heart failure regardless of ejection fraction at ~£7,800 per QALY gained.
Why the study?
Although empagliflozin is approved with proven clinical effectiveness across heart failure phenotypes, its cost-effectiveness in treating the entire heart failure population remained unknown.
Does empagliflozin added to standard of care improve cost-effectiveness compared to standard of care alone in adults with symptomatic chronic heart failure irrespective of ejection fraction?
Does empagliflozin added to standard of care improve cost-effectiveness compared to standard of care alone in adults with symptomatic chronic heart failure irrespective of ejection fraction?
Empagliflozin added to standard of care is highly cost-effective for the treatment of symptomatic chronic heart failure across the entire ejection fraction spectrum in England.
Answers are grounded in this paper and cite their sources.
Supports cost-effective use of empagliflozin in HF across EF spectrum; leaves open need for real-world validation.
AIMS: Heart failure (HF) is a complex syndrome commonly categorized into two main phenotypes [left ventricular ejection fraction (LVEF) below or above 40%], and although empagliflozin is the first approved medication with proven clinical effectiveness for both phenotypes, its cost-effectiveness of treating the entire HF population remains unknown. METHODS: The analysis was performed utilizing two preexisting, LVEF phenotype-specific cost-effectiveness models to estimate the cost-effectiveness of empagliflozin in adults for the treatment of symptomatic chronic HF, irrespective of ejection fraction (EF). The results of the phenotype-specific models were combined using a population-weighted approach to estimate the deterministic and probabilistic incremental cost-effectiveness ratios (ICERs). RESULTS: Based on combined results, empagliflozin + standard of care (SoC) is associated with 6.13 life-years (LYs) and 3.92 quality-adjusted life-years (QALYs) compared with 5.98 LYs and 3.76 QALYs for SoC alone over a lifetime, resulting in an incremental difference of 0.15 LYs and 0.16 QALYs, respectively. Total lifetime healthcare costs per patient are £15 246 for empagliflozin + SoC and £13 982 for SoC giving an incremental difference of £1264. The ICER is £7757/QALY, which is substantially lower than the willingness-to-pay (WTP) of £30 000 per QALY used by NICE. The results of the probabilistic sensitivity analyses are in line with the deterministic results. CONCLUSION: Empagliflozin is the first efficacious, approved, and cost-effective treatment option for all HF patients, irrespective of EF. The combined ICER was consistently below the WTP threshold. Therefore, empagliflozin offers value for money for the treatment of the full HF population in England.
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Kolovos et al. (2023) studied Heart failure. Empagliflozin vs. Standard of care was evaluated on Incremental cost-effectiveness ratio (ICER) per QALY gained (ICER £7757/QALY). Empagliflozin plus standard of care is a cost-effective treatment for heart failure regardless of ejection fraction, yielding an incremental cost-effectiveness ratio of £7,757 per QALY gained.
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