Evidence mapPaperPMID 31379124Full record

Observational studyDiabetes, obesity & metabolism2019

Dapagliflozin vs non-SGLT-2i treatment is associated with lower healthcare costs in type 2 diabetes patients similar to participants in the DECLARE-TIMI 58 trial: A nationwide observational study.

Anna Norhammar, Johan Bodegard, Thomas Nyström, Marcus Thuresson, Klas Rikner, David Nathanson, Jan W Eriksson

Abstract readObservational Study
In one paragraph

Observational study in Diabetes, obesity & metabolism, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Dapagliflozin for Heart Failure with Preserved Ejection Fraction: Will the DELIVER Study Deliver?Diabetes therapy : research, treatment and education of diabetes and related disorders · 2020
    Review
  8. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Anna NorhammarCardiology Unit, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden and Capio S:t Görans Hospital, Stockholm, Sweden.
Johan BodegardAstraZeneca Europe & Canada, Oslo, Norway.ORCID 0000-0001-5423-3967
Thomas NyströmDepartment of Clinical Science and Education, Division of Internal Medicine, Unit for Diabetes Research, Södersjukhuset, Stockholm, Sweden.
Marcus ThuressonStatisticon AB, Uppsala, Sweden.
Klas RiknerAstraZeneca Nordic-Baltic, Södertälje, Sweden.
David NathansonDivision of Internal Medicine, Unit for Diabetes Research, Karolinska University Hospital, Stockholm, Sweden.
Jan W ErikssonDepartment of Medical Sciences, Clinical Diabetes and Metabolism, Uppsala University, Uppsala, Sweden.ORCID 0000-0002-2639-9481

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsTo investigate how the cardiovascular (CV) risk benefits of dapagliflozin translate into healthcare costs compared with other non-sodium-glucose cotransporter-2 inhibitor glucose-lowering drugs (oGLDs) in a real-world population with type 2 diabetes (T2D) that is similar to the population of the DECLARE-TIMI 58 trial.

methodsPatients initiating dapagliflozin or oGLDs between 2013 and 2016 in Swedish nationwide healthcare registries were included if they fulfilled inclusion and exclusion criteria of the DECLARE-TIMI 58 trial (DECLARE-like population). Propensity scores for the likelihood of dapagliflozin initiation were calculated, followed by 1:3 matching with initiators of oGLDs. Per-patient cumulative costs for hospital healthcare (in- and outpatient) and for drugs were calculated from new initiation until end of follow-up.

resultsA total of 24 828 patients initiated a new GLD; 6207 initiated dapagliflozin and 18 621 initiated an oGLD. After matching based on 96 clinical and healthcare cost variables, groups were balanced at baseline. Mean cumulative 30-month healthcare cost per patient was similar in the dapagliflozin and oGLD groups ($11 807 and $11 906, respectively; difference, -$99; 95% CI, -$629, $483; P = 0.644). Initiation of dapagliflozin rather than an oGLD was associated with significantly lower hospital costs (-$658; 95% CI, -$1169, -$108; P = 0.024) and significantly higher drug costs ($559; 95% CI, $471, $648; P < 0.001). Hospital cost difference was related mainly to fewer CV- and T2D-associated complications with use of dapagliflozin compared with use of an oGLD (-$363; 95% CI, -$665, -$61; P = 0.008).

conclusionIn a nationwide, real-world, DECLARE-like population, dapagliflozin was associated with lower hospital costs compared with an oGLD, mainly as a result of reduced rates of CV- and T2D-associated complications.

Indexed as

AgedBenzhydryl CompoundsDiabetes Mellitus, Type 2FemaleGlucosidesHealth Care CostsHospitalizationHumansHypoglycemic AgentsMaleMiddle AgedSodium-Glucose Transporter 2 InhibitorsSwedenBenzhydryl CompoundsdapagliflozinGlucosidesHypoglycemic AgentsSodium-Glucose Transporter 2 Inhibitors

Identifiers

PMID31379124
PMCPMC6899855

What Socratic holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.