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Dapagliflozin Versus Sacubitril–Valsartan to Improve Outcomes of Patients with Reduced Ejection Fraction and Diabetes Mellitus

Dapagliflozin Versus Sacubitril–Valsartan to Improve Outcomes of Patients with Reduced Ejection... BackgroundComorbid heart failure with reduced ejection fraction (HFrEF) and type 2 diabetes mellitus (DM) is associated with a very high risk of HF events. Sacubitril–valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), and dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, improve HF outcomes in these patients, but their comparative value for money in this patient population has not yet been determined.ObjectiveWe aimed to compare the cost needed to treat (CNT) to avoid an HF event with each drug.MethodsCNT was estimated by multiplying the annualized number needed to treat (NNT) to prevent one HF event by the annual cost of each therapy. HF events were defined as the first event of hospitalization for HF or cardiovascular mortality. Drug efficacy data were extracted from published secondary analyses of patients with DM in the DAPA-HF and PARADIGM-HF trials. Drug costs were estimated as 75% of the 2021 US National Average Drug Acquisition Cost listing. Sensitivity analysis was performed on parameters that may have affected the CNT.ResultsThe annualized NNT was 24 (95% confidence interval [CI] 16–54) for dapagliflozin and 57 (95% CI 31–433) for the ARNI. At an annual cost of $US4523 and 5099, respectively, the CNT was $US108,563 (95% CI 72,375–244,267) for dapagliflozin and $US290,671 (95% CI 158,084–2,208,079) for the ARNI.ConclusionsDapagliflozin seems to offer greater value for money than the ARNI for patients with HFrEF and DM. Our results provide support for contemporary guidelines advocating the use of dapagliflozin in these patients. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Cardiovascular Drugs Springer Journals

Dapagliflozin Versus Sacubitril–Valsartan to Improve Outcomes of Patients with Reduced Ejection Fraction and Diabetes Mellitus

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Publisher
Springer Journals
Copyright
Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2021
ISSN
1175-3277
eISSN
1179-187X
DOI
10.1007/s40256-021-00506-5
Publisher site
See Article on Publisher Site

Abstract

BackgroundComorbid heart failure with reduced ejection fraction (HFrEF) and type 2 diabetes mellitus (DM) is associated with a very high risk of HF events. Sacubitril–valsartan, an angiotensin receptor-neprilysin inhibitor (ARNI), and dapagliflozin, a sodium-glucose cotransporter-2 inhibitor, improve HF outcomes in these patients, but their comparative value for money in this patient population has not yet been determined.ObjectiveWe aimed to compare the cost needed to treat (CNT) to avoid an HF event with each drug.MethodsCNT was estimated by multiplying the annualized number needed to treat (NNT) to prevent one HF event by the annual cost of each therapy. HF events were defined as the first event of hospitalization for HF or cardiovascular mortality. Drug efficacy data were extracted from published secondary analyses of patients with DM in the DAPA-HF and PARADIGM-HF trials. Drug costs were estimated as 75% of the 2021 US National Average Drug Acquisition Cost listing. Sensitivity analysis was performed on parameters that may have affected the CNT.ResultsThe annualized NNT was 24 (95% confidence interval [CI] 16–54) for dapagliflozin and 57 (95% CI 31–433) for the ARNI. At an annual cost of $US4523 and 5099, respectively, the CNT was $US108,563 (95% CI 72,375–244,267) for dapagliflozin and $US290,671 (95% CI 158,084–2,208,079) for the ARNI.ConclusionsDapagliflozin seems to offer greater value for money than the ARNI for patients with HFrEF and DM. Our results provide support for contemporary guidelines advocating the use of dapagliflozin in these patients.

Journal

American Journal of Cardiovascular DrugsSpringer Journals

Published: Oct 21, 2021

References