Cost-Effectiveness of Empagliflozin in Patients with Chronic Heart Failure and Chronic Kidney Disease: A Systematic Review
Abstract
INTRODUCTION
To evaluate the cost-effectiveness of empagliflozin in patients with chronic heart failure with preserved ejection fraction (CHFpEF) and moderately reduced ejection fraction (CHFmrEF) across various healthcare systems.
MATERIALS AND METHODS
A systematic review was conducted according to PRISMA 2024 guidelines. A total of 6 studies were included after screening 225 records from PubMed, Web of Science, ScienceDirect, and Google Scholar. Studies evaluating cost-effectiveness outcomes, including incremental cost-effectiveness ratios (ICER), quality-adjusted life years (QALY), and healthcare costs, were analyzed.
RESULTS
All included studies applied a Markov model over a 10-year time horizon. Empagliflozin was associated with a 15-18% reduction in hospitalizations, an increase in QALYs by 0.11-0.67, and ICERs ranging from €5,089/QALY to $174,053/QALY, depending on the healthcare setting and model assumptions. Examples include: Spain: €5,089/QALY, China: $11,292/QALY, USA: $25,974-$174,053/QALY, Australia: A$29,202/QALY. ICER per life year (LY) ranged from $6,246 to $151,929, indicating variable cost-effectiveness based on country-specific cost structures and thresholds.
CONCLUSIONS
Empagliflozin appears to be a cost-effective add-on therapy to standard care for CHFpEF and CHFmrEF, especially in healthcare systems with high hospitalization costs. However, its value is highly sensitive to drug pricing and national willingness-to-pay thresholds. Further real-world…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
Read the paper
Related studies
- Strategy for Mitigating DKA Risk in Patients with Type 1 Diabetes on Adjunctive Treatment with SGLT Inhibitors: A STICH Protocol
- Glucoraphanin: a broccoli sprout extract that ameliorates obesity-induced inflammation and insulin resistance
- SGLT2 Inhibitors in Heart Failure: Targeted Metabolomics and Energetic Metabolism
- Mechanisms of blood pressure reduction with sodium-glucose co-transporter 2 (SGLT2) inhibitors
- Sodium-glucose cotransporter inhibitors: beyond glycaemic control
- Decoding the effects of SGLT2 inhibitors on cardiac arrhythmias in heart failure
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.