Evidence map›Paper›PMID 32749733›Full record

ArticleEuropean journal of heart failure2020

Cost-effectiveness of dapagliflozin as a treatment for heart failure with reduced ejection fraction: a multinational health-economic analysis of DAPA-HF.

Phil McEwan, Oliver Darlington, John J V McMurray, Pardeep S Jhund, Kieran F Docherty, Michael Böhm, Mark C Petrie, Klas Bergenheim, Lei Qin

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of heart failure, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07700940 (Does The Positive Reno-Protective Effect Of Sodium Glucose Co-Transporter 2 Inhibitors Extend To Lupus Nephritis Population?), which is not on this map. Cited by 73 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
73citing papers in PubMed, 5 pooled it
–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.

NCT07700940 phase4recruitingnot on this mapstarted 2024, after this paper: background citation

Does The Positive Reno-Protective Effect Of Sodium Glucose Co-Transporter 2 Inhibitors Extend To Lupus Nephritis Population?

TypeinterventionalSponsorAhmed Yehia IsmailRan2024 to 2026Enrolled66ConditionsLupus Nephritis (LN)ArmsEmpagliflozin (25 Mg Tab) along with standard medical therapy, Placebo and standard of care
3 · Its place in the literature

Who cites it

73 citing papers in PubMed, 5 syntheses or guidelines pooled it.

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  20. The clinical and pharmacoeconomic impact of established and novel heart failure therapies.European heart journal supplements : journal of the European Society of Cardiology · 2025
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13 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Phil McEwanHealth Economics and Outcomes Research Ltd, Cardiff, UK.
Oliver DarlingtonHealth Economics and Outcomes Research Ltd, Cardiff, UK.
John J V McMurrayBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Pardeep S JhundBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Kieran F DochertyBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Michael BöhmDepartment of Medicine, Saarland University Hospital, Homburg/Saar, Germany.
Mark C PetrieBritish Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
Klas BergenheimAstraZeneca, CVRM Biopharmaceutical, Gothenburg, Sweden.
Lei QinAstraZeneca, CVRM Biopharmaceutical, Gaithersburg, MD, USA.

Funding

British Heart Foundation RE/18/6/34217
6 · The paper itself

Abstract

aimTo estimate the cost-effectiveness of dapagliflozin added to standard therapy, vs. standard therapy only, in patients with heart failure (HF) with reduced ejection fraction (HFrEF), from the perspective of UK, German, and Spanish payers. METHODS AND

resultsA lifetime Markov model was built to estimate outcomes in patients with HFrEF. Health states were defined by Kansas City Cardiomyopathy Questionnaire total symptom score, type 2 diabetes and worsening HF events. The incidence of worsening HF and all-cause mortality was estimated using negative binomial regression models and parametric survival analysis, respectively. Direct healthcare costs (2019 British pounds/Euro) and patient-reported outcomes (EQ-5D) were sourced from the existing literature and the Dapagliflozin And Prevention of Adverse-outcomes in Heart Failure trial (DAPA-HF), respectively; the median duration of follow-up in DAPA-HF was 18.2 months (range: 0-27.8). Future costs and effects were discounted at 3.0% for the Spanish and German analyses and 3.5% for the UK analysis. In the UK setting, treatment with dapagliflozin was estimated to increase life-years and quality-adjusted life-years (QALYs) from 5.62 to 6.20 (+0.58) and 4.13 to 4.61 (+0.48), respectively, and reduce lifetime hospitalizations for HF (925 and 820 events per 1000 patients for placebo and dapagliflozin, respectively). Similar results were obtained for Germany and Spain. The incremental cost-effectiveness ratios were £5822, €5379 and €9406/QALY in the UK, Germany and Spain, respectively. In probabilistic sensitivity analyses, more than 90% of simulations were cost-effective at a willingness-to-pay threshold of £20 000/QALY in UK and €20 000/QALY in Germany and Spain.

conclusionDapagliflozin is likely to be a cost-effective treatment for HFrEF in the UK, German and Spanish healthcare systems.

Indexed as

Benzhydryl CompoundsGlucosidesHeart FailureAgedCost-Benefit AnalysisFemaleGermanyHumansMaleQuality-Adjusted Life YearsSodium-Glucose Transporter 2 InhibitorsSpainVentricular Function, LeftBenzhydryl CompoundsdapagliflozinGlucosidesSodium-Glucose Transporter 2 InhibitorsCost-effectivenessHeart failureHospitalizationQuality of lifeSodium-glucose co-transporter 2Survival

Identifiers

PMID32749733
PMCPMC7756637

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

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.