Key result
SGLT2 inhibitors prove highly cost-effective in Chinese HFrEF patients at ~$9,356 per QALY.
Why the study?
SGLT2 inhibitors demonstrated time-varying effects in HFrEF, but their cost-effectiveness across different timeframes remained poorly understood from the perspective of the Chinese healthcare system.
Does adding SGLT2 inhibitors to standard therapy improve cost-effectiveness in Chinese patients with HFrEF?
Does adding SGLT2 inhibitors to standard therapy improve cost-effectiveness in Chinese patients with HFrEF?
Effect estimate: ICER $9,355.66/QALY
Adding SGLT2 inhibitors to standard therapy is highly cost-effective for Chinese patients with HFrEF, with economic benefits increasing over a 2-year period.
May inform Chinese HFrEF resource allocation; leaves open generalizability from Level 5 modeled data.
Objective: Sodium-glucose cotransporter-2 (SGLT2) inhibitors showed time-varying effects in heart failure and reduced ejection fraction (HFrEF), but corresponding cost-effectiveness in different timeframes remained poorly understood. This study estimated the time-varying cost-effectiveness of SGLT2 inhibitors in HFrEF from the perspective of the Chinese healthcare system. Methods: Based on real-world individual patient data, a 2-year microsimulation model was constructed to evaluate the cost-effectiveness of adding SGLT2 inhibitors to standard therapy compared with standard therapy alone among patients with HFrEF. A published prediction model informed transition probabilities for all-cause death and hospitalization for heart failure. The time-varying effects of SGLT2 inhibitors, medical costs, and utility values were derived from the published literature. Scenario analyses in different timeframes were conducted to assess the trend of cost-effectiveness over time. Results: Compared with standard therapy alone, SGLT2 inhibitors plus standard therapy were found cost-effective at a willingness-to-pay (WTP) threshold of $12,741 per quality-adjusted life year (QALY) gained in 2 years. The incremental cost-effectiveness ratio (ICER) decreased from $12,346.07/QALY at 0.5 years to $9,355.66/QALY at 2 years. One-direction sensitivity analysis demonstrated that the cost-effectiveness of SGLT2 inhibitors was most sensitive to the cost of SGLT2 inhibitors, the cost of hospitalization for heart failure, the cost of standard therapy for heart failure, and the baseline risks of all-cause death and hospitalization for heart failure. Probabilistic sensitivity analysis proved the robustness of the results. Conclusion: Adding SGLT2 inhibitors to standard therapy was found to be cost-effective in Chinese patients with HFrEF. Longer treatment appeared to be more economically favorable, but further explorations are warranted.
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Zou et al. (2025) studied Heart failure and reduced ejection fraction (HFrEF) (n=4,227). SGLT2 inhibitors vs. Standard therapy alone was evaluated on Incremental cost-effectiveness ratio (ICER) (ICER $9,355.66/QALY). Adding SGLT2 inhibitors to standard therapy in Chinese patients with HFrEF was highly cost-effective, yielding an incremental cost-effectiveness ratio of $9,355.66 per QALY gained over 2 years.
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