Cost-effectiveness evaluation of add-on dapagliflozin for heart failure with reduced ejection fraction from perspective of healthcare systems in Asia-Pacific region

doi:10.1186/s12933-021-01387-3

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Title:	Cost-effectiveness evaluation of add-on dapagliflozin for heart failure with reduced ejection fraction from perspective of healthcare systems in Asia-Pacific region
Authors:	Liao, Chia-Te Yang, Chun-Ting Toh, Han Siong Chang, Wei-Ting Chang, Hung-Yu Kuo, Fang-Hsiu Lee, Mei-Chuan Hua, Yi-Ming Tang, Hsin-Ju Strong, Carol Ou, Huang-Tz
Contributors:	Natl Cheng Kung Univ, Coll Med, Dept Publ Hlth Chi Mei Med Ctr, Dept Internal Med, Div Cardiol Southern Taiwan Univ Sci & Technol, Dept Elect Engn Natl Cheng Kung Univ, Coll Med, Inst Clin Pharm & Pharmaceut Sci Chi Mei Med Ctr, Dept Intens Care Med Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Southern Taiwan Univ Sci & Technol, Dept Biotechnol Cheng Hsin Gen Hosp, Heart Ctr Natl Yang Ming Chiao Tung Univ, Fac Med, Sch Med Chi Mei Med Ctr, Dept Pharm Chang Gung Univ Sci & Technol, Dept Nursing Natl Cheng Kung Univ, Coll Med, Dept Pharm
Keywords:	Heart failure Dapagliflozin Cost-effectiveness
Date:	2021
Issue Date:	2023-11-11 11:45:17 (UTC+8)
Publisher:	BMC
Abstract:	Background: With emerging evidence on the efficacy of adding dapagliflozin to standard care for patients with heart failure with reduced ejection fraction (HFrEF), this study assessed the cost-effectiveness of add-on dapagliflozin to standard care versus standard care alone for HFrEF from the perspective of healthcare systems in the Asia-Pacific region. Methods: A Markov model was applied to project the outcomes of treatment in terms of lifetime medical cost and quality-adjusted life-years. The transition probabilities between health states in the model were obtained from the Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction trial. Country-specific costs and utilities were extracted for modeling. The incremental cost-effectiveness ratio against a country-specific willingness-to-pay threshold was applied to determine the cost-effectiveness of treatment. A series of sensitivity analyses were performed to ensure the robustness of the study results. Costs are presented in 2020 United States dollars. Results: The incremental cost-effectiveness ratios for add-on dapagliflozin versus standard care alone were $5277, $9980, $12,305, $16,705, and $23,227 per quality-adjusted life-year gained in Korea, Australia, Taiwan, Japan, and Singapore, respectively. When using add-on dapagliflozin to standard care versus standard care alone, similar to 100% of simulations were cost-effective at a willingness-to-pay threshold of one gross domestic product per capita of the given Asia-Pacific country; however, the probability of being cost-effective for using add-on dapagliflozin decreased when the time horizon for simulation was restricted to 18 months and when the cardiovascular mortality for the two treatments (43.8% and 33.0%, respectively) was assumed to be the same. The cost-effectiveness results were most sensitive to cardiovascular mortality of treatment. Conclusions: Adding dapagliflozin to standard care is cost-effective for HFrEF in healthcare systems in the Asia-Pacific region, which supports the rational use of dapagliflozin for HFrEF in this region.
Relation:	CARDIOVASC DIABETOL, v.20, n.1, pp.204
Appears in Collections:	[Dept. of Health and Nutrition (including master's program)] Periodical Articles

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