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Table 3 Outcomes and Main Measures of the Studies

From: Cost-effectiveness analysis of dapagliflozin in the management of heart failure with reduced ejection fraction (HFrEF): a systematic review

Comparator

Types of cost included

Cost

Effectiveness

ICER (USD/QALY)

WTP (per QALY)

Ref.

SCT

Medication costs, add-on dapagliflozin, HF hospitalizations, and urgent visit HF costs

Incremental costs of dapagliflozin vs. SCT:

Dapagliflozin plus SCT:

Dapagliflozin plus SCT vs SCT:

$100,000

[21]

 1. All patients: $42,800

 1. All patients: 5.36

 1. All patients: $68,300

 2. No diabetes:$40,100

 2. No diabetes: 5.86

 2. No diabetes: $69,600

 3. Diabetes: $46,500

 3. Diabetes: 4.66

 3. Diabetes: $66,800

 

SCT alone:

 
 

 1. All patients: 4.73

 
 

  2. No diabetes: 5.28

 
 

 3. Diabetes: 3.96

 

SCT

Medication costs, treatment, monitoring, adverse events, worsening HF events, and CV death

-UK:

-UK:

Dapagliflozin plus SCT vs SCT only:

UK: £20000 ,Germany and Spain : €20000 in

[18]

 1. Dapagliflozin plus SCT: $21821.9

 1. Dapagliflozin plus SCT: 4.61

 UK: $7743

 2. SCT only: $18,124.6

 2. SCT only:4.13

 Germany: $6143

-Germany:

-Germany:

 Spain: $10742

 1. Dapagliflozin plus SCT: $28925.4

 1. Dapagliflozin plus SCT:4.72

 

 2. SCT only: $25,863.6

 2. SCT only:4.22

 

- Spain:

-Spain:

 

 1. Dapagliflozin plus SCT: $27,785.7

 1. Dapagliflozin plus SCT:4.72

 

 2. SCT only: $22,431.8

 2. SCT only:4.22

 

SCT

Hospitalization, prescription medications for HF, HF-associated readmissions in hospitals and specialist visit fees

Model 1.

Model 1.

Model 1.

$8573.4

[23]

 1. Dapagliflozin plus SCT: $5,829.4

 1. Dapagliflozin plus SCT: 4.82

 18-month time horizon: $14,883

 2. SCT only: $4,377.1

 2. SCT only:4.44

 15-year time horizon: $3827.6

Model 2.

Model 2.

Model 2.

 1. Dapagliflozin plus SCT: $5,858.4

 1. Dapagliflozin plus SCT: 4.82

Dapagliflozin plus standard care vs. standard care only:

 2. SCT only: $4,436.6 

 2. Standard care only: 4.44 

 $3732.3 

SCT

1. Direct: Healthcare services and medications, 2. Indirect: loss of productivity caused by morbidity and mortality

-Costs in different time horizons:

-In different time horizons:

Add-on dapagliflozin vs. SCT alone: Korea: $5277

$25,000 and $75,000

[20]

 (a) 18 months:

 (a) 18 months:

Australia: $9980

  1. Dapagliflozin plus SCT: $16,719

  1. Dapagliflozin plus SCT:2.10

Japan: $16,705

  2. SCT: $15,732

  2. SCT: 2.08

Singapore: $23,227

 (b)30 years:

 (b)30 years:

Taiwan:

  1. Dapagliflozin plus SCT: $104,632

  1. Dapagliflozin plus SCT: 13.14

-Based ICER: $12,305

  2. SCT: $87,940

  2. SCT: 11.6

-Different Time Horizons:

-Costs in different discount rates:

-In different discount rates:

 (a) 30 years: $10,832

 (a) 0%:

 (a) 0%:

 (b) 18 months: $37,386

  1. Dapagliflozin plus SCT: $104,288

  1. Dapagliflozin plus SCT:13.1

-Different discounting rates:

  2. SCT: $90,112

  2. SCT:11.89

 (a) 0%: $11,681

 (b)10%:

 (b)10%:

 (b) 10%: $13,007

  1. Dapagliflozin plus SCT: $62,215

  1. Dapagliflozin plus SCT:7.82

 

  2. SCT: $55,130

  2. SCT:7.25

 

SCT

Hospitalization, medicines, and treatment of adverse events

1. Dapagliflozin plus SCT: $1747.8

1. Dapagliflozin plus standard therapy: 6.92

Dapagliflozin plus standard care vs standard care only: $1991 per QALY

$5131

[25]

2. Standard care only: $559.3

2. Standard care only:6.33

SCT

Costs of medicines, HF hospitalization, and adverse event management

N.R

N.R

Dapagliflozin plus standard therapy vs standard therapy:

180,500 PHP

[19]

- All patients:

 (A) PHP40: $3108

 (B) PHP44: $3,6380

 (C) PHP46.5: $3,638

-Diabetic:

 (A) PHP40: $2,708

 (B) PHP44: $2,560

 (C) PHP46.5: $2,321

-Non-diabetic:

 (A) PHP40: $5698

 (B) PHP44: $5372

 (C) PHP46.5: $4852

SCT

Cost of dapagliflozin and SCT, HF hospitalization, and death

1. Dapagliflozin plus standard therapy: 19,627.8 AUD

1. Dapagliflozin SCT: 2.8

Dapagliflozin plus standard care vs standard care only: 8,861 AUD

50,000 AUD

[22]

2. Standard care only: 17,079.6 AUD

2. SCT only: 2.5

SCT

Dispensing fees, the drug plan payment, and the beneficiary copayment

1. Dapagliflozin:

1. Dapagliflozin:

Dapagliflozin vs standard of care: total $83650

$100,000 and $150,000

[17]

 (A) Mild impairment: $202,646

 (A) Mild impairment:6.7

 (A) Mild: $78,483

 (B) Moderate impairment: $172,045

 (B) Moderate impairment: 4.2

 (B) Moderate: $97,608

2. SCT:

2. SCT:

 

 (A) Mild impairment:$157,833

 (A) Mild impairment: 6.1

 

 (B) Moderate impairment: $141,783 

 (B) Moderate impairment: 3.9 

 

SCT

Medicines, follow-up, clinical events by the AEs of the medicines or morbidity of the disease (HF care, emergency medical consultation, amputation, diabetic ketosis)

-All patients:

-All patients:

SCT plus dapagliflozin vs. SCT plus Placebo:

Variable

[24]

 1. Dapagliflozin plus standard therapy: $4,611.2

 1. Dapagliflozin plus standard therapy: 2.689

 -All patients

 2. Standard care plus placebo: $3,808.3

 2. SCT plus placebo: 2.554

  $5,946

-Diabetic patients:

-Diabetic patients:

 -Diabetic patients:

1- Dapagliflozin plus standard therapy: $5,476

1- Dapagliflozin plus standard therapy: 3.475

  $4,881.2

2- Standard care plus placebo: $4,767

2- SCT plus placebo: 3.313

 -Non-diabetic patients:

-Non-diabetic patients:

-Non-diabetic patients

  $6,867.5

1. Dapagliflozin plus standard therapy: $3,926

1. Dapagliflozin plus standard therapy: 3.734

 

2. Standard care plus placebo: $3,054.5

2. SCT plus placebo: 3.603

 

SCT alone and in combination with empagliflozin

The standard treatment cost included ACEI, ARBs,

Dapagliflozin group: $4,870.68

1. Dapagliflozin plus SCT: 3.87

$5,541 in the dapagliflozin strategy and $6,946 in the empagliflozin strategy.

$11,008

[16]

Beta-blockers, spironolactone, and diuretic. The cost of hospitalization for HF was from the China

Empagliflozin group: $5,021.93

2. SCT alone (control 1): 3.64

Health Statistics Yearbook 2020, which included town-level,

Control 1 group from DAPA-HF trial: $3,596.25

1. Empagliflozin plus SCT: 3.66

County-level, municipal, provincial, and ministerial hospitals.

Control 2 group from EMPEROR-Reduced: $4,118.86

2. SCT alone (control 2): 3.53

  1. aSCT standard care therapy, ICER incremental cost-effectiveness ratio, QALY quality-adjusted life-years, USD United States dollars, HF heart failure, CV cardiovascular, N.R: not reported, PHP Philippine peso, AUD Australian dollars, AE adverse events, ACEI angiotensin-converting enzyme inhibitors, ARB angiotensin receptor blockers, WTP willingness to pay threshold