Cost-Utility Analysis of Combination Empagliflozin and Standard Treatment Versus Standard Treatment Alone in Thai Heart Failure Patients with Reduced or Preserved Ejection Fraction
Issued Date
2022-09-01
Resource Type
ISSN
11753277
eISSN
1179187X
Scopus ID
2-s2.0-85133645108
Pubmed ID
35796952
Journal Title
American Journal of Cardiovascular Drugs
Volume
22
Issue
5
Start Page
577
End Page
590
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Cardiovascular Drugs Vol.22 No.5 (2022) , 577-590
Suggested Citation
Krittayaphong R., Permsuwan U. Cost-Utility Analysis of Combination Empagliflozin and Standard Treatment Versus Standard Treatment Alone in Thai Heart Failure Patients with Reduced or Preserved Ejection Fraction. American Journal of Cardiovascular Drugs Vol.22 No.5 (2022) , 577-590. 590. doi:10.1007/s40256-022-00542-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/85604
Title
Cost-Utility Analysis of Combination Empagliflozin and Standard Treatment Versus Standard Treatment Alone in Thai Heart Failure Patients with Reduced or Preserved Ejection Fraction
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Background: Clinical trials reported the benefit of empagliflozin when combined with standard treatment relative to cardiovascular death or heart failure (HF) hospitalization in patients with heart failure with reduced or preserved ejection fraction (HFrEF and HFpEF, respectively). We conducted a cost-utility analysis of combination empagliflozin and standard treatment (ST) versus ST alone in Thai HF patients with HFrEF or HFpEF. Methods: A Markov model was employed to capture lifetime direct medical costs and outcomes from a healthcare system perspective. Two cohorts (HFrEF and HFpEF) with an average age of 60 years were enrolled. The clinical inputs were the results of the EMPEROR-Reduced and EMPEROR-Preserved studies, and a Thai database. Costs were gathered from published studies or from a Thai hospital database. Utilities were obtained from published studies. All costs and outcomes were discounted at a rate of 3% per annum. Incremental cost-effectiveness ratios (ICERs) were estimated, and sensitivity analyses were performed. Results: In patients with HFrEF, add-on empagliflozin yielded a life-year gain of 0.26, and a quality-adjusted life-year (QALY) gain of 0.20 at an increased total cost of 409.82 USD compared to ST alone [ICER: 69,218 THB/QALY (2064.98 USD/QALY gained)]. Among HFpEF patients, add-on empagliflozin yielded a life-year gain of 0.07, and a QALY gain of 0.05 at an increased total cost of 622.49 USD compared to ST alone [ICER: 395,826 THB/QALY (11,809 USD/QALY gained)]. Conclusions: At the local Thai threshold of 4773.27 USD/QALY, empagliflozin is a cost-effective add-on treatment for patients with HFrEF, but not for patients with HFpEF.