A European multinational cost-effectiveness analysis of empagliflozin in heart failure with reduced ejection fraction

Ali Tafazzoli (), Odette S. Reifsnider (), Leana Bellanca (), Jack Ishak (), Marc Carrasco (), Pal Rakonczai (), Matthew Stargardter () and Stephan Linden ()
Additional contact information
Ali Tafazzoli: Evidera
Odette S. Reifsnider: Evidera
Leana Bellanca: Boehringer Ingelheim Ltd.
Jack Ishak: Evidera
Marc Carrasco: Boehringer Ingelheim España S.A
Pal Rakonczai: Evidera
Matthew Stargardter: Evidera
Stephan Linden: Boehringer Ingelheim International GmbH

The European Journal of Health Economics, 2023, vol. 24, issue 9, No 4, 1454 pages

Abstract: Abstract Purpose This research examined the cost-effectiveness of adding empagliflozin to standard of care (SoC) compared with SoC alone for treatment of heart failure with reduced ejection fraction (HFrEF) from the perspective of healthcare payers in the United Kingdom (UK), Spain and France. Methods A lifetime Markov cohort model was developed to simulate patients’ progression through health states based on Kansas City Cardiomyopathy Questionnaire Clinical Summary Score. The model predicted risk of death, hospitalisation for worsening heart failure (HHF), treatment-related adverse events, and treatment discontinuation each monthly cycle. Clinical inputs and utilities were derived from EMPEROR-Reduced trial data, supplemented by published literature and national costing databases. Costs (2021 pound sterling/euro) and quality-adjusted life-years (QALYs) were discounted annually for the UK (3.5%), Spain (3.0%) and France (2.5%). Results In the UK, Spain and France, empagliflozin plus SoC yielded additional QALYs (0.19, 0.23 and 0.21) at higher cost (£1185, €1770 and €1183 per patient) than SoC alone, yielding incremental cost-effectiveness ratios of £6152/QALY, €7736/QALY and €5511/QALY, respectively. Reduced HHF incidence provided most cost offsets for empagliflozin plus SoC. Similar results were obtained for a range of subgroups and sensitivity analyses. Probabilistic sensitivity results indicated empagliflozin plus SoC remained cost-effective vs. SoC at willingness-to-pay thresholds of £20,000/QALY, €20,000/QALY and €30,000/QALY in 79.6%, 75.5% and 97.3% of model runs for the UK, Spain and France, respectively. Conclusions Empagliflozin added to SoC leads to health benefits for patients with HFrEF and is a cost-effective treatment option for payers in multiple European countries (UK, Spain, France).

Keywords: Cost-effectiveness; Empagliflozin; Heart failure; Hospitalisation; Reduced ejection fraction; Sodium–glucose cotransporter-2 inhibitor (search for similar items in EconPapers)
JEL-codes: C69 I19 (search for similar items in EconPapers)
Date: 2023
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
http://link.springer.com/10.1007/s10198-022-01555-6 Abstract (text/html)
Access to the full text of the articles in this series is restricted.

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:spr:eujhec:v:24:y:2023:i:9:d:10.1007_s10198-022-01555-6

Ordering information: This journal article can be ordered from
http://www.springer. ... cs/journal/10198/PS2

DOI: 10.1007/s10198-022-01555-6

Access Statistics for this article

The European Journal of Health Economics is currently edited by J.-M.G.v.d. Schulenburg

More articles in The European Journal of Health Economics from Springer, Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ) Contact information at EDIRC.
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().