The cost-effectiveness of dapagliflozin in treating high-risk patients with type 2 diabetes mellitus: An economic evaluation using data from the DECLARE-TIMI 58 trial



McEwan, Phil, Morgan, Angharad R, Boyce, Rebecca, Bergenheim, Klas, Gause-Nilsson, Ingrid AM, Bhatt, Deepak L, Leiter, Lawrence A, Johansson, Peter A, Mosenzon, Ofri, Cahn, Avivit
et al (show 1 more authors) (2021) The cost-effectiveness of dapagliflozin in treating high-risk patients with type 2 diabetes mellitus: An economic evaluation using data from the DECLARE-TIMI 58 trial. DIABETES OBESITY & METABOLISM, 23 (4). pp. 1020-1029.

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Abstract

<h4>Aim</h4>To undertake a cost-effectiveness analysis of dapagliflozin in treating high-risk patients with type 2 diabetes mellitus (T2DM), using both directly observed events in the DECLARE-TIMI 58 trial and surrogate risk factors to predict endpoints not captured within the trial.<h4>Methods</h4>An established T2DM model was adapted to integrate survival curves derived from the DECLARE-TIMI 58 trial, and extrapolated over a lifetime for all-cause mortality, hospitalization for heart failure, stroke, myocardial infarction, hospitalization for unstable angina, and end-stage kidney disease. The economic analysis considered the overall DECLARE trial population, as well as reported patient subgroups. Total and incremental costs, life-years and quality-adjusted life-years associated with dapagliflozin versus placebo were estimated from the perspective of the UK healthcare payer.<h4>Results</h4>In the UK setting, treatment with dapagliflozin compared to placebo was estimated to be dominant, with an expected increase in quality-adjusted life-years from 10.43 to 10.48 (+0.06) and a reduction in lifetime total costs from £39 451 to £36 899 (-£2552). Across all patient subgroups, dapagliflozin was estimated to be dominant, with the greatest absolute benefit in the prior heart failure subgroup (incremental lifetime costs -£4150 and quality-adjusted life-years +0.11).<h4>Conclusions</h4>The results of this study demonstrate that dapagliflozin compared to placebo appears to be cost-effective, when considering evidence reported from the DECLARE-TIMI 58 trial, at established UK willingness-to-pay thresholds. The findings highlight the potential of dapagliflozin to have a meaningful impact in reducing the economic burden of T2DM and its associated complications across a broad T2DM population.

Item Type: Article
Uncontrolled Keywords: cost-effectiveness, dapagliflozin, SGLT2 inhibitor, type 2 diabetes
Depositing User: Symplectic Admin
Date Deposited: 11 Feb 2021 10:37
Last Modified: 18 Jan 2023 23:00
DOI: 10.1111/dom.14308
Open Access URL: https://doi.org/10.1111/dom.14308
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3115487