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 |