文献类型：期刊文献

英文题名：Cost-effectiveness of adding dapagliflozin to standard treatment for heart failure with reduced ejection fraction patients in China

作者：Yao, Younan[1];Zhang, Rongcheng[1];An, Tao[1];Zhao, Xinke[2];Zhang, Jian[1]

第一作者：Yao, Younan

通信作者：Zhang, J[1]

机构：[1]Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Fuwai Hosp, State Key Lab Cardiovasc Dis,Heart Failure Ctr, 167 Beilishi Rd, Beijing 100037, Peoples R China;[2]Gansu Univ Chinese Med, Affiliated Hosp, Cardiovasc Ctr, Lanzhou, Peoples R China

第一机构：Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Fuwai Hosp, State Key Lab Cardiovasc Dis,Heart Failure Ctr, 167 Beilishi Rd, Beijing 100037, Peoples R China

通信机构：[1]corresponding author), Chinese Acad Med Sci & Peking Union Med Coll, Natl Ctr Cardiovasc Dis, Fuwai Hosp, State Key Lab Cardiovasc Dis,Heart Failure Ctr, 167 Beilishi Rd, Beijing 100037, Peoples R China.

年份：2020

卷号：7

期号：6

起止页码：3582

外文期刊名：ESC HEART FAILURE

收录：;Scopus(收录号：2-s2.0-85093936632);WOS:【SCI-EXPANDED(收录号:WOS:000583630600001)】；

基金：This work was supported by the Key Projects in the National Science and Technology Pillar Program of the 13th Five-Year Plan Period (grant 2017YFC1308300 to J.Z,).

语种：英文

外文关键词：Dapagliflozin; HFrEF; Cost; effectiveness; China

摘要：Aims This study was to determine the cost-effectiveness of dapagliflozin in heart failure with reduced ejection fraction (HFrEF) patients in China from a perspective of health care payers. Methods and results We built a Markov model to perform a cost-effectiveness analysis comparing standard treatment + dapagliflozin (10 mg, q.d.) with standard treatment for HFrEF. The base case in our simulation was a 65-year-old HFrEF patient and was modelled over 15 years. Inputs of the model were derived from the Dapagliflozin and Prevention of Adverse Outcomes in Heart Failure trial and other relevant data from China. Costs, quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER) were estimated for adding dapagliflozin relative to standard treatment. Costs and QALY were discounted at a 4.2% rate annually. All costs are presented in 2017 US dollars. Dapagliflozin would be considered very cost-effective if the ICER was lower than a willingness-to-pay (WTP) threshold of $8573.4. Uncertainty was assessed in our model using one-way, two-way, and probabilistic sensitivity analysis (PSA). In our base case, compared with standard treatment, adding dapagliflozin was more expensive ($5829.4 vs. $4377.1) but more effective (4.82 vs. 4.44 QALYs). The respondent ICER was $3827.6 per QALY gained at 15-year follow-up. When the simulated horizon was longer than 3.5 years, the respondent ICER became lower than the WTP threshold. The inputs with the largest impact on ICER were the cost of dapagliflozin, the cardiovascular mortality in both groups, and the cost of hospitalization for heart failure. Most results of sensitivity analysis were robust. PSA showed a similar result as the base case (ICER = $4412.5 per QALY gained). In Monte Carlo simulation, at a WTP threshold of $8573.4 per QALY, dapagliflozin was considered very cost-effective in 53.10% of the simulations. Conclusions Dapagliflozin was a very cost-effective treatment option for HFrEF patients in China according to the result of our model. Our findings will help doctors and health care payers to make decisions in clinical practice. Future real-world studies of cost-effectiveness of dapagliflozin based on Chinese population were also needed.