OBJECTIVES

Diabetes is one of the major risk factors for cardiovascular disease, while the combination of diabetes and cardiovascular diseases further elevates the risk of death. The EMPA-REG OUTCOME trial demonstrated that T2DM patients at high risk of cardiovascular events who received empagliflozin experienced reduced rates of the primary composite cardiovascular outcome and of death from any cause.

This study aims to assess the financial impact of empagliflozin for T2DM patients at high CV risk in South Korea from a Korean health care perspective.

METHODS

An Excel-based budget impact model was used to compare treatment with and without empagliflozin on top of SoC for 3 years on direct medical cost. All adult (age ≥20) T2DM patients with T2DM were collected from HIRA Healthcare Big-data hub. The model considered T2DM patients with high CV risk based upon EMPA-REG OUTCOME. Treatment patterns and clinical inputs were extracted from the Asian patient subpopulation of EMPA-REG OUTCOME trial. Empagliflozin patients share was estimated based on UBIST market trend data and the Diabetes guideline for the whole 3-year time horizon.

Clinical event related costs were derived from the 2017 HIRA National Patients Sample (HIRA-NPS) data. Anti-diabetes drug acquisition costs as SoCs were collected by class from 2017 HIRA report and reflected the WHO Defined Daily Doses.

RESULTS

The addition of empagliflozin to SoC reduced direct medical costs with 1,911 million KRW in year 1 (Y1), 3,610 million KRW in Y2 and 5,371 million KRW in Y3. The additional drug acquisition costs for empagliflozin were more than offset by the reductions in the costs of managing clinical events. The reductions in the use of other anti-diabetic medicines as SoC contributed to further savings.

CONCLUSIONS

Empagliflozin for T2DM patients at high CV risk direct reduces direct medical costs in South Korea. These savings were driven by the reduction in clinical events.