OBJECTIVES: Based on the latest treatment recommendations, the use of sodium–glucose cotransporter-2 (SGLT2) inhibitors or glucagon-like peptide 1 (GLP-1) receptor agonists is suggested for patients with type 2 diabetes mellitus (T2DM) and high risk or established atherosclerotic cardiovascular disease (ASCVD). The aim of this study was to estimate the budgetary impact of increasing the use of empagliflozin for the management of these patients in Greece from a public payer perspective.

METHODS: A 5-year (2020-2024) budget impact model was developed to delineate the financial implications of increasing empagliflozin use versus GLP-1 agents for the treatment of T2DM patients with high risk or established ASCVD. Epidemiological data were retrieved from literature and local clinical expert. Market share scenarios with and without the increased market uptake of empagliflozin applied to the eligible Greek patient population. Pharma’s projection estimates were used for building up the market shares of the analyses. Costs related to drug acquisition were considered and unit costs were retrieved from Greek official sources (€, 2020). Key outcomes were total and per patient incremental costs, calculated by comparing the respective total and patient-level budget expenditures with and without the increased use of empagliflozin.

RESULTS: The total and patient-level savings resulting from the increased use of empagliflozin compared to the current market treatment mix were estimated at €48,314,161 (-9.03%) and €372, respectively, over 5 years. On average, annual total and patient-level savings of €9,662,832 (-8.79%) and €74 were calculated. Over time, the gradual increase in empagliflozin market share was associated with greater cost savings for the public payer, ending with the highest total savings (€14,474,508 [-11.80%]) by 2024 (at empagliflozin highest share: 50%).

CONCLUSIONS: This budget impact analysis suggests the increased use of empagliflozin versus GLP-1s represents a cost-saving strategy for the treatment of T2DM patients with high risk or established ASCVD in Greece.