Cost-utility of dapagliflozin plus standard treatment compared to standard treatment for the management of heart failure with reduced ejection fraction in Colombia

ABSTRACT

Introduction

The DAPA-HF study has shown that dapagliflozin added to standard treatment reduced the risks of worsening of heart failure or cardiovascular death compared to placebo.

Objectives

To evaluate the cost- utility of dapagliflozin in combination with standard treatment compared to standard treatment alone for the treatment of heart failure with reduced ejection fraction from the perspective of the Colombian health system.

Methods

A Markov model using information from the DAPA-HF study was adapted to the Colombian setting. Health states considered symptom score, and transient health states were included to assess the incidence of consultations and hospitalizations for heart failure. The time horizon was 5 years and a 5% discount rate was applied. The costs were expressed in US dollars of 2020 (1 USD =$3,693.36 COP).

Results

The incremental cost-effectiveness ratio (ICER) of the intervention compared to standard treatment was USD $5,946 per quality adjusted life year gained. The ICER remained below the cost-effectiveness threshold in sub-group analyses. 97% of sensitivity analysis simulations showed an ICER below the cost-effectiveness threshold.

Conclusion

From the perspective of the analysis, the addition of dapagliflozin to standard treatment is a cost-effective option in patients with heart failure with reduced ejection fraction in Colombia.

KEYWORDS:

• Colombia
• cost-effectiveness
• dapagliflozin
• heart failure
• hospitalization

Author contributions

Y Gil-Rojas and P Lasalvia were responsible for the literature review, cost estimation and data analysis, as well as the conception and final revision of the manuscript. AG contributed to the conception of the study and final revision of the manuscript.

Declaration of interests

Y Gil-Rojas and P Lasalvia report grants from AstraZeneca, during the conduct of the study. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Supplementary material

Supplemental data for this article can be accessed here.

Additional information

Funding

This study was funded by AstraZeneca Colombia.