OBJECTIVES: Empagliflozin is the only treatment indicated for adult patients with symptomatic chronic heart failure (CHF), regardless of left ventricular ejection fraction (LVEF). The efficacy and safety of empagliflozin, added to optimized standard of care (SoC) therapy, have been demonstrated in two randomized, double-blinded clinical trials: EMPEROR-Reduced in adult patients with symptomatic CHF with reduced LVEF, and EMPEROR-Preserved with LVEF>40%. The aim of this study is to evaluate the direct health costs associated to CHF patients after the introduction of empagliflozin in Spain.

METHODS: A model was developed to analyze the management, treatment and its associated costs, of adult patients with non-diabetic CHF, in which two scenarios were compared: one representing current practice and the other the scenario where empagliflozin is introduced. The Spanish National Health System (NHS) perspective and a time horizon of three years were considered. The population with non-diabetic CHF and market shares were estimated according to the type of CHF and literature, considering a progressive introduction of empagliflozin. Patients already treated with a sodium-dependent glucose co-transporter 2 inhibitor were excluded in the analysis. Clinical events (hospitalizations and deaths), adverse events and disease management were obtained from the empagliflozin studies and literature. Unit costs were obtained from literature and national databases and updated to €2022. In addition, sensitivities analysis were carried out.

RESULTS: More than 436,000 symptomatic non-diabetic CHF people per year were estimated in Spain. Over the 3 years considered, more than 3,500 heart failure hospitalizations and more than 700 cardiovascular deaths would be avoided because of empagliflozin plus SoC. In turn, empagliflozin would save the Spanish NHS around €2.4 million, €4.6 million and €5.9 million each year, respectively.

CONCLUSIONS: Empagliflozin would result in clinical benefit to adult patients with non-diabetic CHF regardless of the LVEF, providing substantial cost-savings for the Spanish NHS.