Objective: Quantify the expected health costs and benefits of dapagliflozin use in addition to the standard of care for the treatment of adult patients with heart failure and reduced ejection fraction (HFrEF), from the perspective of Mexico’s Public Health System.

Methods: Dapagliflozin is indicated in patients with NYHA class I, II, III or IV heart failure, who are on standard therapy and yet are symptomatic and have an ejection fraction of 40% or less, so its direct comparator was sacubitrilo/valsartan. According to the evidence collected through a systematic review, a network meta-analysis concluded that there was no statistically significant difference in outcomes like hospitalization for heart failure (HF) or cardiovascular (CV) death between dapagliflozin and sacubitril/valsartan, both in addition to recommended therapy. Therefore a cost minimization analysis was performed from the perspective of the Mexican public health system. The annual cost of drugs was estimated through the recommended doses. Sensitivity analyzes and a budget impact analysis (BIA) were conducted.

Results: The use of dapagliflozin for the treatment of adult patients with HFrEF represents annual savings per patient of 68.1% compared to sacubitril/valsartan. BIA shows an average annual saving of 0.22% in the medicines and pharmaceuticals budget of the public health system in Mexico. Sensitivity analyses suggest that the conclusions of the base case are robust.

Conclusions: Dapagliflozin is now transforming the approach of treating patients with HFrEF, as it has shown positive results in terms of reducing hospitalizations due to HF or CV death. Considering the serious problem of morbidity and mortality related to this disease and the costs for the health system, patients and family members, it is important to have innovative therapies that can generate savings, in that sense, dapagliflozin has proven to be an efficient treatment for HFrEF.