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- Title
Eligibility and Cost-Utility Analysis of Dapagliflozin in Patients with Heart Failure Across the Whole Spectrum of Ejection Fraction in South Korea.
- Authors
Kim, Eui-Soon; Park, Sun-Kyeong; Cho, Daniel Sung-ho; Youn, Jong-Chan; Lee, Hye Sun; Lee, Hae-Young; Cho, Hyun-Jai; Choi, Jin-Oh; Jeon, Eun-Seok; Lee, Sang Eun; Kim, Min-Seok; Kim, Jae-Joong; Hwang, Kyung-Kuk; Cho, Myeong-Chan; Chae, Shung Chull; Kang, Seok-Min; Park, Jin Joo; Choi, Dong-Ju; Yoo, Byung-Su; Cho, Jae Yeong
- Abstract
Background: The DAPA-HF and DELIVER trials demonstrated the clinical benefits of dapagliflozin in heart failure (HF) patients across the entire ejection fraction (EF) spectrum. However, further investigation is needed for the real-world application of dapagliflozin in HF patients. This study examines the proportion of real-world HF patients eligible for dapagliflozin and evaluates the cost-effectiveness of adding dapagliflozin to current HF therapy. Methods: Data from the nationwide prospective registry, the Korean Acute Heart Failure (KorAHF) registry, were used to determine dapagliflozin eligibility based on the enrollment criteria of the DAPA-HF/DELIVER trials. A cost-utility analysis was conducted using a Markov model to assess the cost-effectiveness of dapagliflozin by comparing it to the standard of care. Results: Out of 5178 KorAHF patients, 48.7% met the enrollment criteria of the DAPA-HF/DELIVER trials, while 89.5% met the label criteria (US Food and Drug Administration, European Medicines Agency, and Korean Ministry of Food and Drug Safety). Eligibility was highest among HF patients with preserved EF (55.3% vs. HF with mildly reduced EF and HF with reduced EF 46.4%). Dapagliflozin proved to be cost-effective, with an incremental cost-effectiveness ratio (ICER) of 4557 US dollar (US$) per quality-adjusted life year, which falls below the US$18,182 willingness-to-pay threshold. The cost-effectiveness benefit was more pronounced in patients with a left ventricular EF (LVEF) ≤ 40% (ICER US$3279 for LVEF ≤ 40% vs. US$8383 for LVEF > 40%). Conclusions: Discrepancies in dapagliflozin eligibility were observed between real-world data and clinical trial results. The addition of dapagliflozin to HF therapy proved to be highly cost-effective across the entire EF spectrum.
- Subjects
SOUTH Korea; STATISTICAL models; VENTRICULAR ejection fraction; COST effectiveness; RESEARCH funding; DAPAGLIFLOZIN; HEART failure; COST benefit analysis; DESCRIPTIVE statistics; ELIGIBILITY (Social aspects); MEDICAL care costs; COMORBIDITY
- Publication
American Journal of Cardiovascular Drugs, 2024, Vol 24, Issue 2, p313
- ISSN
1175-3277
- Publication type
Article
- DOI
10.1007/s40256-024-00632-w