Cost-Effectiveness Evaluation of Add-on Empagliflozin in Patients With Heart Failure and a Reduced Ejection Fraction From the Healthcare System's Perspective in the Asia-Pacific Region

doi:10.3389/fcvm.2021.750381

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Title:	Cost-Effectiveness Evaluation of Add-on Empagliflozin in Patients With Heart Failure and a Reduced Ejection Fraction From the Healthcare System's Perspective in the Asia-Pacific Region
Authors:	Liao, Chia-Te Yang, Chun-Ting Kuo, Fang-Hsiu Lee, Mei-Chuan Chang, Wei-Ting Tang, Hsin-Ju Hua, Yi-Ming Chang, Hung-Yu Chen, Zhih-Cherng Strong, Carol Ou, Huang-Tz Toh, Han Siong
Contributors:	Natl Cheng Kung Univ, Dept Publ Hlth, Coll Med Chi Mei Med Ctr, Div Cardiol, Dept Internal Med Southern Taiwan Univ Sci & Technol, Dept Elect Engn Natl Cheng Kung Univ, Inst Clin Pharm & Pharmaceut Sci, Coll Med Chi Mei Med Ctr, Dept Pharm Natl Cheng Kung Univ, Inst Clin Med, Coll Med Southern Taiwan Univ Sci & Technol, Dept Biotechnol Chang Gung Univ Sci & Technol, Dept Nursing Natl Yang Ming Chiao Tung Univ, Sch Med, Fac Med Cheng Hsin Gen Hosp, Ctr Heart Natl Cheng Kung Univ, Dept Pharm, Coll Med Chi Mei Med Ctr, Dept Intens Care Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
Keywords:	cost-effectiveness empagliflozin SGLT2 inhibitor heart failure with a reduced ejection fraction (HFrEF) systolic heart failure Asia-Pacific
Date:	2021
Issue Date:	2023-11-11 11:44:52 (UTC+8)
Publisher:	FRONTIERS MEDIA SA
Abstract:	Background: EMPEROR-Reduced trial provides promising evidence on the efficacy of empagliflozin adding to the standard treatment in patients with heart failure and reduced ejection fraction (HFrEF). This study aimed to investigate the cost-effectiveness of add-on empagliflozin vs. standard therapy alone in HFrEF from the perspective of the Asia-Pacific healthcare systems. Methods: A Markov model was constructed to simulate HFrEF patients and to project the lifetime direct medical costs and quality-adjusted life years (QALY) of both therapies. Transitional probabilities were derived from the EMPEROR-Reduced trial. Country-specific costs and utilities were extracted from published resources. Incremental cost-effectiveness ratio (ICER) against willingness to pay (WTP) threshold was used to examine the cost-effectiveness. A series of sensitivity analyses was performed to ensure the robustness of the results. Results: The ICERs of add-on empagliflozin vs. standard therapy alone in HFrEF were US$20,508, US$24,046, US$8,846, US$53,791, US$21,543, and US$20,982 per QALY gained in Taiwan, Japan, South Korea, Singapore, Thailand, and Australia, respectively. Across these countries, the probabilities of being cost-effective for using add-on empagliflozin under the WTP threshold of 3-times country-specific gross domestic product per capita were 93.7% in Taiwan, 95.6% in Japan, 96.3% in South Korea, 94.2% Singapore, 51.9% in Thailand, and 95.9% in Australia. The probabilities were reduced when shortening the time horizon, assuming the same cardiovascular mortality for both treatments, and setting lower WTP thresholds. Conclusion: Adding empagliflozin to HFrEF treatment is expected to be a cost-effective option among the Asia-Pacific countries. The cost-effectiveness is influenced by the WTP thresholds of different countries.
Relation:	FRONT CARDIOVASC MED, v.8, pp.750381
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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