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AuthorAbushanab, Dina
AuthorChbib, Salma
AuthorKaddoura, Rasha
AuthorAl Hail, Moza
AuthorAbdul Rouf, Palli Valappila
AuthorEl Kassem, Wessam
AuthorShah, Jassim
AuthorRavindran Nair, Ramesh Kumar
AuthorAl-Badriyeh, Daoud
Available date2024-04-29T08:33:53Z
Publication Date2024-03-11
Publication NameJournal of Medical Economics
Identifierhttp://dx.doi.org/10.1080/13696998.2024.2322258
CitationAbushanab, D., Chbib, S., Kaddoura, R., Al Hail, M., Abdul Rouf, P. V., El Kassem, W., ... & Al-Badriyeh, D. (2024). Cost‑effectiveness of add‑on dapagliflozin for heart failure with reduced ejection fraction patients without diabetes. Journal of Medical Economics, 27(1), 404-417.
ISSN1369-6998
URIhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85187489327&origin=inward
URIhttp://hdl.handle.net/10576/54442
AbstractAim: To evaluate the cost-effectiveness of dapagliflozin added to standard of care (SoC) versus SoC in heart failure with reduced ejection fraction (HFrEF) and without type 2 diabetes mellitus (T2DM) patients from the Qatari healthcare perspective. Materials and Methods: A lifetime Markov model was developed to evaluate the cost-effectiveness of adding dapagliflozin to SoC based on the findings of Petrie et al. 2020, which were based on the DAPA-HF trial. The model was constructed based on four health states: “alive with no event”, “urgent visit for heart failure”, “hospitalization for heart failure”, and “dead”. The model considered 1,000 hypothetical HFrEF and without T2DM patients using 3-month cycles over a lifetime horizon. The outcome of interest was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year gained (QALY) and years of life lived (YLL). Utility and cost data were obtained from published sources. A scenario analysis was performed to replace the transition probabilities of events in people without T2DM with the transition probabilities of events irrespective of T2DM status, based on findings of the DAPA-HF trial. Sensitivity analyses were conducted to confirm the robustness of the conclusion. Results: Adding dapagliflozin to SoC was estimated to dominate SoC alone, resulting in 0.6 QALY and 0.8 YLL, at a cost saving of QAR771 (USD211) per person compared with SoC alone, with total healthcare costs of QAR42,413 (USD 11,620) versus 43,184 (USD11,831) per person, respectively. When replacing the transition probabilities of events in people without T2DM with the transition probabilities of events in people irrespective of T2DM status, dapagliflozin was cost-effective at ICER of QAR5,212 (USD1,428) per QALY gained and QAR3,880 (USD1,063) per YLL. In the probabilistic sensitivity analysis, dapagliflozin combined with SoC was cost saving in over 49% of the cases and cost-effective in over 43% of the simulated cases against QALYs gained and YLL. Limitations: Data from clinical trials were used instead of local data, which may limit the local relevance. However, evidence from the local Qatari population is lacking. Also, indirect costs were not included due to a paucity of available data. Conclusions: Adding dapagliflozin to SoC is likely to be a cost-saving therapy for patients with HFrEF and without T2DM in Qatar.
SponsorOpen Access funding was provided by the Qatar National Library.
Languageen
PublisherTaylor & Francis
Subjectcost saving
cost-effectiveness
Dapagliflozin
heart failure
non-diabetes
TitleCost‑effectiveness of add‑on dapagliflozin for heart failure with reduced ejection fraction patients without diabetes
TypeArticle
Pagination404-417
Issue Number1
Volume Number27
ESSN1941-837X
dc.accessType Open Access


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