PMID- 32800910
OWN - NLM
STAT- MEDLINE
DCOM- 20210527
LR  - 20210527
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 322
DP  - 2021 Jan 1
TI  - Cost-utility analysis of add-on dapagliflozin treatment in heart failure with 
      reduced ejection fraction.
PG  - 183-190
LID - S0167-5273(20)33544-0 [pii]
LID - 10.1016/j.ijcard.2020.08.017 [doi]
AB  - BACKGROUND: Dapagliflozin is an antidiabetic medication that has been shown to 
      reduce the risk of heart failure hospitalization and cardiovascular death in 
      patients with heart failure with reduced ejection fraction (HFrEF). This study 
      aimed to determine the cost-utility of add-on dapagliflozin treatment for HFrEF. 
      METHODS: An analytical decision model was constructed to assess lifetime costs 
      and outcomes from a healthcare system perspective. The cohort comprised HFrEF 
      patients with left ventricular ejection fraction (LVEF) </=40%, and New York Heart 
      Association (NYHA) class II-IV with an average age of 65 years. Clinical inputs 
      were derived from the results of the Dapagliflozin and Prevention of 
      Adverse-Outcomes in Heart Failure (DAPA-HF) trial. Risk of non-cardiovascular 
      death data, readmission rate data, and treatment-related cost data were based on 
      Thai population. The outcomes and costs were discounted at 3% annually. A series 
      of sensitivity analyses were also conducted. RESULTS: The increased cost of 
      dapagliflozin add-on treatment from 17,442 THB (559 USD) to 54,405 THB (1745 USD) 
      was associated with a QALY gain from 6.33 to 6.92 compared to standard therapy, 
      yielding an ICER of 62,090 THB/QALY (1991 USD/QALY). Sensitivity analyses 
      revealed that the addition of dapagliflozin to the standard treatment 
      demonstrated an 87% cost-effectiveness strategy at a level of willingness to pay 
      (WTP) of 160,000 THB/QALY (5131 USD/QALY). ICER was higher in non-diabetes 
      compared to diabetes (68,304 vs 47,613 THB/QALY or 2191 vs 1527 USD/QALY). 
      CONCLUSIONS: Dapagliflozin is a cost-effective add-on therapy for patients with 
      HFrEF at a WTP of 160,000 THB/QALY (5131 USD/QALY).
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Krittayaphong, Rungroj
AU  - Krittayaphong R
AD  - Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj 
      Hospital, Mahidol University, Bangkok, Thailand.
FAU - Permsuwan, Unchalee
AU  - Permsuwan U
AD  - Department of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, 
      Chiang Mai, Thailand. Electronic address: unchalee.permsuwan@cmu.ac.th.
LA  - eng
PT  - Journal Article
DEP - 20200813
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Benzhydryl Compounds)
RN  - 0 (Glucosides)
RN  - 1ULL0QJ8UC (dapagliflozin)
SB  - IM
MH  - Aged
MH  - Benzhydryl Compounds
MH  - Cost-Benefit Analysis
MH  - Glucosides
MH  - *Heart Failure/diagnosis/drug therapy
MH  - Humans
MH  - Stroke Volume
MH  - Thailand
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Cost-
OT  - Dapagliflozin
OT  - Heart failure
OT  - SGLT2 inhibitor
OT  - Thailand
COIS- Declaration of Competing Interest The authors report no relationships that could 
      be construed as a conflict of interest.
EDAT- 2020/08/18 06:00
MHDA- 2021/05/28 06:00
CRDT- 2020/08/18 06:00
PHST- 2020/05/06 00:00 [received]
PHST- 2020/06/19 00:00 [revised]
PHST- 2020/08/07 00:00 [accepted]
PHST- 2020/08/18 06:00 [pubmed]
PHST- 2021/05/28 06:00 [medline]
PHST- 2020/08/18 06:00 [entrez]
AID - S0167-5273(20)33544-0 [pii]
AID - 10.1016/j.ijcard.2020.08.017 [doi]
PST - ppublish
SO  - Int J Cardiol. 2021 Jan 1;322:183-190. doi: 10.1016/j.ijcard.2020.08.017. Epub 
      2020 Aug 13.