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Cost Effectiveness of Adding Dapagliflozin to Standard Care in Heart Failure Patients with Reduced Ejection Fraction: A Systematic Review

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Abstract

Introduction

Dapagliflozin, a new treatment option for heart failure, leads to a significant reduction in the hospitalization of patients with heart failure. We aimed to review studies on the economic evaluation of adding dapagliflozin to standard care compared with standard care alone in heart failure patients with reduced ejection fraction (HFrEF).

Methods

For this systematic review, the PubMed, EMBASE, Web of Science, Cochrane, Scopus, and CEA Registry scientific databases were searched from 1 January 2020 to 25 March 2022. Two of the present researchers screened titles and abstracts, extracted data from full-text articles, and evaluated their quality using the Quality of Health Economic Studies (QHES) checklist for the quality assessment of health economic studies.

Results

Of the 456 abstracts screened, 19 studies met the inclusion criteria. The mean QHES score for the studies was 0.87 (high quality). Eight studies on cost-effectiveness analysis, ten studies on cost-utility analysis, and one study on cost-minimization analysis were conducted. Based on the available evidence and the present findings, the addition of dapagliflozin to standard care in patients with HFrEF was cost effective in most countries.

Conclusions

Based on the results of the present study, the addition of dapagliflozin to standard care in patients with HFrEF was cost effective. More studies investigating the cost effectiveness of dapagliflozin in patients with HFrEF are required in light of the actual epidemiological data of countries in the relevant input parameters. It is also recommended to conduct cost-effectiveness studies of dapagliflozin taking into account costs and benefits from a societal perspective.

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Author information

Authors and Affiliations

  1. Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran

    Aziz Rezapour, Hassan Abolghasem Gorji & Negar Yousefzadeh

  2. Psychiatry and Behavioral Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran

    Mahsa Tashakori-Miyanroudi

  3. Cardiac Electrophysiology Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran

    Majid Haghjoo

  4. Department of English Language Teaching, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

    Mohammad Barzegar

  5. School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

    Parvin Tatarpour

  6. Dept. of Health Services and Health Promotion, School of Health, Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran

    Aghdas Souresrafil

  7. Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

    Mohammadreza Sheikhy-Chaman

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  1. Aziz Rezapour
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Correspondence to Aghdas Souresrafil.

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Funding

This work was supported by the Health Management and Economics Research Center, Iran University of Medical Sciences (grant numbers 1400-1-48-20651) and has been approved by the National Committee of Ethics in Biomedical Research (IR.IUMS.REC.1400.1140).

Conflict of interest

Aziz Rezapour, Mahsa Tashakori-Miyanroudi, Majid Haghjoo, Mohammad Barzegar, Parvin Tatarpour, Aghdas Souresrafil, Hassan Abolghasem Gorji, Negar Yousefzadeh, and Mohammadreza Sheikhy-Chaman declare that they have no potential conflicts of interest that might be relevant to the contents of this manuscript.

Author contributions

Conceptualization: AR, AS, MH. Literature search: MT-M, PT, NY, MS-H. Quality assessment of studies: AR, AS, MH. Formal analysis: AR, MH, AS, HAG, PT. Writing – original draft preparation: AR, AS, MT-M, PT, MB. Writing – review and editing: HAG, NY, MB, MS-H.

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All data generated and/or analyzed during this study are included in this published article.

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Rezapour, A., Tashakori-Miyanroudi, M., Haghjoo, M. et al. Cost Effectiveness of Adding Dapagliflozin to Standard Care in Heart Failure Patients with Reduced Ejection Fraction: A Systematic Review. Am J Cardiovasc Drugs 23, 127–144 (2023). https://doi.org/10.1007/s40256-022-00564-3

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