Cost-effectiveness of Empagliflozin in Patients With Heart Failure With Preserved Ejection Fraction
Abstract
Importance
In the Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Preserved Ejection Fraction (EMPEROR-Preserved), empagliflozin significantly reduced hospitalizations for heart failure while improving patient-reported health status compared with placebo. The long-term cost-effectiveness of empagliflozin among patients who have heart failure with preserved ejection fraction (HFpEF) remains unclear.
Objective
To estimate the cost-effectiveness of empagliflozin in patients with HFpEF.
Design, Setting, and Participants
This cost-effectiveness analysis performed from October 2021 to April 2022 included a Markov model using estimates of treatment efficacy, event probabilities, and utilities from EMPEROR-Preserved and published literature. Costs were derived from national surveys and pricing data sets. Quality of life was imputed from a heart failure-specific quality-of-life measure. Two analyses were performed, with and without a treatment effect on cardiovascular mortality. Subgroup analyses were based on diabetes status, ejection fraction, and health status impairment due to heart failure. The model reproduced the event rates and risk reduction with empagliflozin observed in EMPEROR-Preserved over 26 months of follow-up; future projections extended across the lifetime of patients.
Exposures
Empagliflozin or standard of care.
Main Outcomes and Measures
Hospitalizations for heart failure, life-years, quality-adjusted life-years (QALYs), lifetime costs, and…
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