• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • 2MM Podcast
  • Write for us
  • Contact Us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan+
  • Classics™+
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Cardiology

Sodium-glucose cotransporter-2 inhibitors are of intermediate or low economic value in the treatment of heart failure with preserved ejection fraction

byGursharan SohiandYuchen Dai
March 16, 2023
in Cardiology, Chronic Disease
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Sodium-glucose cotransporter-2 inhibitors (SGLT2-I) in combination with standard of care were found to increase quality-adjusted life-years at a cost of $26,000 compared to standard of care alone.

2. Amongst 1000 probabilistic models, 59.1% predicted SGLT2-I added intermediate value, and 40.9% predicted low value.

Level of Evidence Rating: 2 (Good)

Study Rundown: Sodium-glucose cotransporter-2 inhibitor (SGLT2-I) medications have become central to managing heart failure, diabetes mellitus and renal disease in recent years. Although associated with significant clinical benefits, SGLT2-I remains a proprietary medication with an annual cost of approximately $8,000 USD. The present study by Cohen et al. sought to determine the cost-effectiveness of SGLT2-I added to the standard of care management of heart failure with preserved ejection fraction.

Over 2.3 years, adding SGLT2-I to the standard of care reduced mean hospitalizations due to heart failure and increased mean survival from 7.73 to 7.95 years. Lifetime quality-adjusted life-years (QALYs) also increased from 5.27 to 5.46, with a cost increase of $26 312. The lifetime ICER of adding SGLT2-I to the standard of care was $141 200 per QALY gained. Across 1000 probabilistic iterations, this was found to be an intermediate or low-value intervention. Interestingly, if half of all eligible patients in the United States were to receive SGLT2-I therapy in addition to the standard of care, the budget for healthcare expenditures would have to increase by approximately $4.3 billion annually.

This economic analysis by Cohen et al. demonstrated that SGLT2-I medications are of intermediate cost effectiveness, increasing quality-adjusted life years by 0.19 years and associated with a cost increase of $26,300. The cost-effectiveness of this strategy would be improved by lowering medication costs and wholesale acquisition costs. A strength of this study is that clinical data were derived from two large, randomized controlled trials representing tier-one evidence. Additionally, the thoroughness of the analysis demonstrated a high degree of real-world applicability. A major limitation of this study is the inability to account for all health benefits associated with SGLT2-I, including renoprotective effects. Further studies should focus on identifying strategies to reduce costs associated with this drug class and to identify the subgroup of patients for which therapy is cost-effective.

RELATED REPORTS

Anal cancer screening cost-effective for men who have sex with men with human immunodeficiency virus aged above 35 years

#VisualAbstract: Dapagliflozin Reduced Death and Worsening Heart Failure in Transcatheter Aor-tic-Valve Implantation

Novel colorectal cancer screening tests’ utility depends on patient context

Click here to read this study in JAMA Cardiology

Click to read an accompanying editorial in JAMA Cardiology

Relevant reading: Empagliflozin, Health Status, and Quality of Life in Patients with Heart Failure and Preserved Ejection Fraction: the EMPEROR-preserved trial

In-Depth [cost-effectiveness analysis]: A lifetime cost-effectiveness analysis from the perspective of the United States healthcare sector was conducted. A Markov model was used to predict the lifetime costs associated with adding an SGLT2-I (empagliflozin or dapagliflozin) to the standard of care for heart failure with preserved ejection fraction. Patient eligibility criteria for inclusion in the Markov model are derived from the EMPEROR-preserved and DELIVER trials. The trial duration was 2.3 years; therefore, mortality rates for this period were derived from the results of these studies; hospitalizations and risk of death from heart failure were derived from the control arm data in each.

In the EMPEROR-preserved and DELIVER trials, SGLT2-I significantly decreased hospitalizations due to heart failure (hazard ratio 0.74, 95% confidence interval 0.67-0.83) and a trend towards reduced cardiovascular death (0.88, 0.77-1.00). The base-case cost of annual SGLT2-I therapy was $4506, with sensitivity analysis scenarios ranging from $1415-6620. Finally, quality of life data was derived from the Kansas City Cardiomyopathy Questionnaire.

Over 2.3 years, adding SGLT2-I to the standard of care was found to reduce mean hospitalizations due to heart failure (from 0.74 [0.65-0.87] to 0.53 [0.44-0.63]) and increase mean survival from 7.73 (7.65-7.80) to 7.95 (7.68-8.20) years. Lifetime quality-adjusted life-years (QALYs) were also increased from 5.27 (5.22-5.33) to 5.46 (5.29-5.62), accompanied by a cost increase of $26 312 ($20 290-$31 722). The lifetime ICER of adding SGLT2-I to the standard of care was $141 200 per QALY gained. Across 1000 probabilistic iterations, this was found to be an intermediate (59.1%) or low (40.9%) value intervention.

Image: PD

©2023 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: cost effectiveness analysisDELIVEREMPEROR-PreservedHFpEF (heart failure with preserved ejection fractionSGLT-2 inhibitors
Previous Post

Ultrasound ablation of globus pallidus reduces Parkinson’s disease motor symptoms

Next Post

Secukinumab reduces symptoms of moderate-to-severe hidradenitis suppurativa

RelatedReports

Government-funded initiatives provide important supports to low-income HIV patients
Infectious Disease

Anal cancer screening cost-effective for men who have sex with men with human immunodeficiency virus aged above 35 years

June 16, 2025
#VisualAbstract: Dapagliflozin Reduced Death and Worsening Heart Failure in Transcatheter Aor-tic-Valve Implantation
StudyGraphics

#VisualAbstract: Dapagliflozin Reduced Death and Worsening Heart Failure in Transcatheter Aor-tic-Valve Implantation

April 18, 2025
Significant reduction in prostate screening rates after revised guidelines
Public Health

Novel colorectal cancer screening tests’ utility depends on patient context

November 4, 2024
Endocrinology

Similar neuroprotective effects from sodium-glucose cotransporter-2 inhibitors and dulaglutide

August 26, 2024
Next Post
Hidradenitis suppurativa associated with increased risk of subclinical atherosclerosis

Secukinumab reduces symptoms of moderate-to-severe hidradenitis suppurativa

Pulmonary MRI with ultrashort echo time is comparable to pulmonary CT

Black patients with pulmonary fibrosis may have worse outcomes compared to other populations

Decreased expression of nasal ACE2 may be correlated with lower prevalence of COVID-19 in children

Prior COVID-19 infection may result in poorer sleep health

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Structured Exercise after Adjuvant Chemotherapy for Colon Cancer
  • 2 Minute Medicine Rewind June 30, 2025
  • Weighted vests and resistance training confer similar outcomes for bone density in the elderly
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • All Specialties, All Recent Reports
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Pharma
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • AI Roundup
  • Pharma
  • The Scan
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Podcasts
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account
No Result
View All Result

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.