OBJECTIVES

Heart failure (HF) is associated with high morbidity, mortality and significant excess financial expenditure. Dapagliflozin, a sodium-glucose co-transporter-2 (SGLT-2) inhibitor, has shown the benefit in lowering the risk of worsening heart failure or death from cardiovascular (CV) causes in heart failure with reduced ejection fraction (HFrEF) patients compared with placebo. This analysis estimated medical costs differences among HFrEF patients treated with dapagliflozin versus placebo, in addition to recommended therapy in China.

METHODS

A cost-offset model has been developed to quantify the short-term difference in medical costs associated with dapagliflozin and placebo of worsening HF events, including hospitalization, urgent visit, and death related costs. Event rates and mortality rates were derived from the DAPA-HF trial data. Unit costs of clinical events from China healthcare perspective were obtained from literatures and physician interviews. The model estimated the medical costs of patients with HFrEF over 3 years from the patient-level. One-way sensitivity analysis (OWSA) was performed to test the robustness of the results, where each variable was varied one at time by ±20% changes relative to the base case values.

RESULTS

The base case showed the 3-year total medical cost per patient was RMB 7,464 for dapagliflozin and RMB 9,519 for placebo, indicating a cost-saving of RMB 2,055 of using dapagliflozin versus placebo. Due to smaller number of events occurred for dapagliflozin vs. placebo, RMB 1,450 saved for hospitalization cost, RMB 61 for urgent visit cost, and RMB 544 for death related cost when treated with dapagliflozin. OWSA confirmed the cost savings for the comparison examined, hospitalization rate for HF was identified as driving the highest variations in the cost-offset assessment.

CONCLUSIONS

The results of this cost-offset analysis showed that treatment of dapagliflozin was associated with significantly lower event rates than placebo, consequently dapagliflozin provides cost savings versus placebo among HFrEF patients in China.