Cost-effectiveness evaluation of add-on dapagliflozin for heart failure with reduced ejection fraction from perspective of healthcare systems in Asia-Pacific region

被引:16
|
作者
Liao, Chia-Te [1 ,2 ,3 ]
Yang, Chun-Ting [4 ]
Toh, Han Siong [5 ,6 ]
Chang, Wei-Ting [2 ,7 ]
Chang, Hung-Yu [8 ,9 ]
Kuo, Fang-Hsiu [2 ]
Lee, Mei-Chuan [1 ,10 ]
Hua, Yi-Ming [10 ]
Tang, Hsin-Ju [11 ]
Strong, Carol [1 ]
Ou, Huang-Tz [4 ,12 ]
机构
[1] Natl Cheng Kung Univ, Coll Med, Dept Publ Hlth, Tainan, Taiwan
[2] Chi Mei Med Ctr, Dept Internal Med, Div Cardiol, Tainan, Taiwan
[3] Southern Taiwan Univ Sci & Technol, Dept Elect Engn, Tainan, Taiwan
[4] Natl Cheng Kung Univ, Coll Med, Inst Clin Pharm & Pharmaceut Sci, Tainan, Taiwan
[5] Chi Mei Med Ctr, Dept Intens Care Med, Tainan, Taiwan
[6] Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr, Tainan, Taiwan
[7] Southern Taiwan Univ Sci & Technol, Dept Biotechnol, Tainan, Taiwan
[8] Cheng Hsin Gen Hosp, Heart Ctr, Taipei, Taiwan
[9] Natl Yang Ming Chiao Tung Univ, Fac Med, Sch Med, Taipei, Taiwan
[10] Chi Mei Med Ctr, Dept Pharm, Tainan, Taiwan
[11] Chang Gung Univ Sci & Technol, Dept Nursing, Chiayi, Taiwan
[12] Natl Cheng Kung Univ, Coll Med, Dept Pharm, Tainan, Taiwan
关键词
Heart failure; Dapagliflozin; Cost-effectiveness; BURDEN;
D O I
10.1186/s12933-021-01387-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: With emerging evidence on the efficacy of adding dapagliflozin to standard care for patients with heart failure with reduced ejection fraction (HFrEF), this study assessed the cost-effectiveness of add-on dapagliflozin to standard care versus standard care alone for HFrEF from the perspective of healthcare systems in the Asia-Pacific region. Methods: A Markov model was applied to project the outcomes of treatment in terms of lifetime medical cost and quality-adjusted life-years. The transition probabilities between health states in the model were obtained from the Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction trial. Country-specific costs and utilities were extracted for modeling. The incremental cost-effectiveness ratio against a country-specific willingness-to-pay threshold was applied to determine the cost-effectiveness of treatment. A series of sensitivity analyses were performed to ensure the robustness of the study results. Costs are presented in 2020 United States dollars. Results: The incremental cost-effectiveness ratios for add-on dapagliflozin versus standard care alone were $5277, $9980, $12,305, $16,705, and $23,227 per quality-adjusted life-year gained in Korea, Australia, Taiwan, Japan, and Singapore, respectively. When using add-on dapagliflozin to standard care versus standard care alone, similar to 100% of simulations were cost-effective at a willingness-to-pay threshold of one gross domestic product per capita of the given Asia-Pacific country; however, the probability of being cost-effective for using add-on dapagliflozin decreased when the time horizon for simulation was restricted to 18 months and when the cardiovascular mortality for the two treatments (43.8% and 33.0%, respectively) was assumed to be the same. The cost-effectiveness results were most sensitive to cardiovascular mortality of treatment. Conclusions: Adding dapagliflozin to standard care is cost-effective for HFrEF in healthcare systems in the Asia-Pacific region, which supports the rational use of dapagliflozin for HFrEF in this region.
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页数:10
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