A cost-effectiveness analysis of empagliflozin for heart failure patients across the full spectrum of ejection fraction in Spain: combined results of the EMPEROR-Preserved and EMPEROR-Reduced trials

Figures & data

Figure 1. Diagram of the approach to calculate the combined ICER from the base-case results of the two phenotype-specific CEMs.

* Population weighting was performed on the health and cost model outcomes, i.e. LYs, QALYs, and total healthcare costs of each treatment arm (empagliflozin + SoC and SoC), separately. Abbreviations: CEM, cost-effectiveness model; HF, heart failure; HFrEF, heart failure with reduced ejection fraction; HF > 40%EF, heart failure with > 40% ejection fraction; ICER, incremental cost-effectiveness ratio; LY, life-year; QALY, quality-adjusted life-year; SoC, standard of care.

Table 1. Combined deterministic results for the overall ITT population.

Cost-effectiveness measures	Empagliflozin + SoC	SoC
Total LYs	6.48	6.35
Total QALYs	4.80	4.63
Total costs	€19,090	€18,246
ICER (cost/LY gained)	€6,246
ICER (cost/QALY gained)	€5,089

Abbreviations: ICER, incremental cost-effectiveness ratio; ITT, intention-to-treat; LY, life-year; QALY, quality-adjusted life-year; SoC, standard of care.

Figure 2. Cost-effectiveness plane for empagliflozin + SoC compared to SoC alone for the overall ITT population. The graph visually represents the incremental differences in costs and QALYs between treatment groups.

Abbreviations: ITT, intention-to-treat; QALY, quality-adjusted life-year; PSA, probabilistic sensitivity analysis; SoC, standard of care; WTP, willingness-to-pay.

Figure 3. Cost-effectiveness acceptability curve for empagliflozin + SoC compared to SoC alone.

Abbreviations: SoC, standard of care.

Table 2. Results (in terms of ICER) of subgroup analyses.

Subgroup	ICER (cost/QALY gained)	Variation from ITT population (%)
T2DM at baseline	€4,151	−18%
No T2DM at baseline	€5,796	14%
Baseline age <65 years	€4,069	−20%
Baseline age ≥65 years	€6,014	18%
Baseline eGFR <60 mL/min/1.73 m^2	€5,434	7%
Baseline eGFR ≥60 mL/min/1.73 m^2	€4,805	−6%

Abbreviations: eGFR, estimated glomerular filtration rate; ICER, incremental cost-effectiveness ratio; ITT, intention-to-treat; QALY, quality-adjusted life-year; T2DM, type 2 diabetes mellitus.