Abstract：
UNASSIGNED: To evaluate the cost-effectiveness of dapagliflozin added to standard of care (SoC) versus SoC in heart failure with reduced ejection fraction (HFrEF) and without type 2 diabetes mellitus (T2DM) patients from the Qatari healthcare perspective.
UNASSIGNED: A lifetime Markov model was developed to evaluate the cost-effectiveness of adding dapagliflozin to SoC based on the findings of Petrie et al. 2020, which were based on the DAPA-HF trial. The model was constructed based on four health states: \"alive with no event\", \"urgent visit for heart failure\", \"hospitalization for heart failure\", and \"dead\". The model considered 1,000 hypothetical HFrEF and without T2DM patients using 3-month cycles over a lifetime horizon. The outcome of interest was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year gained (QALY) and years of life lived (YLL). Utility and cost data were obtained from published sources. A scenario analysis was performed to replace the transition probabilities of events in people without T2DM with the transition probabilities of events irrespective of T2DM status, based on findings of the DAPA-HF trial. Sensitivity analyses were conducted to confirm the robustness of the conclusion.
UNASSIGNED: Adding dapagliflozin to SoC was estimated to dominate SoC alone, resulting in 0.6 QALY and 0.8 YLL, at a cost saving of QAR771 (USD211) per person compared with SoC alone, with total healthcare costs of QAR42,413 (USD 11,620) versus 43,184 (USD11,831) per person, respectively. When replacing the transition probabilities of events in people without T2DM with the transition probabilities of events in people irrespective of T2DM status, dapagliflozin was cost-effective at ICER of QAR5,212 (USD1,428) per QALY gained and QAR3,880 (USD1,063) per YLL. In the probabilistic sensitivity analysis, dapagliflozin combined with SoC was cost saving in over 49% of the cases and cost-effective in over 43% of the simulated cases against QALYs gained and YLL.
UNASSIGNED: Data from clinical trials were used instead of local data, which may limit the local relevance. However, evidence from the local Qatari population is lacking. Also, indirect costs were not included due to a paucity of available data.
UNASSIGNED: Adding dapagliflozin to SoC is likely to be a cost-saving therapy for patients with HFrEF and without T2DM in Qatar.
Heart failure with reduced ejection fraction is a type of heart failure characterized by left ventricular ejection fraction of 40% or less. Dapagliflozin is a novel therapy for this condition, which was initially designed to treat type 2 diabetes mellitus. It is unclear whether dapagliflozin is a cost-effective option for patients with heart failure with reduced ejection fraction and without type 2 diabetes. A lifetime Markov model was developed to evaluate the cost-effectiveness of adding dapagliflozin to standard of care from the Qatari healthcare perspective. Model results suggest that adding dapagliflozin to standard of care dominated standard of care alone, resulting in a gain of 0.8 years of life lived, a gain of 0.6 quality-adjusted life-years, and a cost saving of 211 United States dollars per person.
UNASSIGNED: A lifetime Markov model was developed to evaluate the cost-effectiveness of adding dapagliflozin to SoC based on the findings of Petrie et al. 2020, which were based on the DAPA-HF trial. The model was constructed based on four health states: \"alive with no event\", \"urgent visit for heart failure\", \"hospitalization for heart failure\", and \"dead\". The model considered 1,000 hypothetical HFrEF and without T2DM patients using 3-month cycles over a lifetime horizon. The outcome of interest was the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year gained (QALY) and years of life lived (YLL). Utility and cost data were obtained from published sources. A scenario analysis was performed to replace the transition probabilities of events in people without T2DM with the transition probabilities of events irrespective of T2DM status, based on findings of the DAPA-HF trial. Sensitivity analyses were conducted to confirm the robustness of the conclusion.
UNASSIGNED: Adding dapagliflozin to SoC was estimated to dominate SoC alone, resulting in 0.6 QALY and 0.8 YLL, at a cost saving of QAR771 (USD211) per person compared with SoC alone, with total healthcare costs of QAR42,413 (USD 11,620) versus 43,184 (USD11,831) per person, respectively. When replacing the transition probabilities of events in people without T2DM with the transition probabilities of events in people irrespective of T2DM status, dapagliflozin was cost-effective at ICER of QAR5,212 (USD1,428) per QALY gained and QAR3,880 (USD1,063) per YLL. In the probabilistic sensitivity analysis, dapagliflozin combined with SoC was cost saving in over 49% of the cases and cost-effective in over 43% of the simulated cases against QALYs gained and YLL.
UNASSIGNED: Data from clinical trials were used instead of local data, which may limit the local relevance. However, evidence from the local Qatari population is lacking. Also, indirect costs were not included due to a paucity of available data.
UNASSIGNED: Adding dapagliflozin to SoC is likely to be a cost-saving therapy for patients with HFrEF and without T2DM in Qatar.
Heart failure with reduced ejection fraction is a type of heart failure characterized by left ventricular ejection fraction of 40% or less. Dapagliflozin is a novel therapy for this condition, which was initially designed to treat type 2 diabetes mellitus. It is unclear whether dapagliflozin is a cost-effective option for patients with heart failure with reduced ejection fraction and without type 2 diabetes. A lifetime Markov model was developed to evaluate the cost-effectiveness of adding dapagliflozin to standard of care from the Qatari healthcare perspective. Model results suggest that adding dapagliflozin to standard of care dominated standard of care alone, resulting in a gain of 0.8 years of life lived, a gain of 0.6 quality-adjusted life-years, and a cost saving of 211 United States dollars per person.
摘要：
■从卡塔尔医疗保健角度评估在射血分数降低(HFrEF)且无2型糖尿病(T2DM)的心力衰竭患者中添加达格列净的治疗标准(SoC)和SoC的成本效益。
■开发了寿命马尔可夫模型，以根据Petrie等人的发现评估将dapagliflozin添加到SoC的成本效益。,2020年，这是基于DAPA-HF试验。该模型是基于四种健康状态构建的：\“没有事件的活着\”，“心力衰竭紧急就诊”，“心力衰竭住院”，和“死”。该模型考虑了1,000个假设的HFrEF和无T2DM患者，在一生中使用3个月的周期。感兴趣的结果是每获得质量调整生命年（QALY）和生命寿命（YLL）的增量成本效益比（ICER）。效用和成本数据是从公布的来源获得的。进行了情景分析，以将无T2DM人群中事件的转移概率替换为事件的转移概率，而与T2DM状态无关。基于DAPA-HF试验的结果。进行了敏感性分析，以证实结论的稳健性。
■在SoC中添加dapagliflozin估计仅在SoC中占主导地位，导致0.6QALY和0.8YLL，与仅SoC相比，每人节省QAR771(USD211)的成本，医疗总费用为QAR42,413（11,620美元），人均为43,184（11,831美元），分别。当用与T2DM状态无关的人中事件的转移概率替换没有T2DM的人中事件的转移概率时,dapagliflozin在ICER上的成本效益为每QALY获得5,212季度（1,428美元），每年获得3,880季度（1,063美元）。在概率敏感性分析中，在超过49％的病例中，dapagliflozin与SoC结合使用可节省成本，在超过43％的模拟病例中，针对获得的QALY和YLL具有成本效益。
■使用临床试验数据代替本地数据，这可能会限制当地的相关性。然而,缺乏来自当地卡塔尔人口的证据。此外，由于缺乏可用数据，间接成本未包括在内。
■在卡塔尔，向SoC中添加达帕格列净可能是HFrEF和无T2DM患者的一种节省成本的治疗方法。
■开发了寿命马尔可夫模型，以根据Petrie等人的发现评估将dapagliflozin添加到SoC的成本效益。,2020年，这是基于DAPA-HF试验。该模型是基于四种健康状态构建的：\“没有事件的活着\”，“心力衰竭紧急就诊”，“心力衰竭住院”，和“死”。该模型考虑了1,000个假设的HFrEF和无T2DM患者，在一生中使用3个月的周期。感兴趣的结果是每获得质量调整生命年（QALY）和生命寿命（YLL）的增量成本效益比（ICER）。效用和成本数据是从公布的来源获得的。进行了情景分析，以将无T2DM人群中事件的转移概率替换为事件的转移概率，而与T2DM状态无关。基于DAPA-HF试验的结果。进行了敏感性分析，以证实结论的稳健性。
■在SoC中添加dapagliflozin估计仅在SoC中占主导地位，导致0.6QALY和0.8YLL，与仅SoC相比，每人节省QAR771(USD211)的成本，医疗总费用为QAR42,413（11,620美元），人均为43,184（11,831美元），分别。当用与T2DM状态无关的人中事件的转移概率替换没有T2DM的人中事件的转移概率时,dapagliflozin在ICER上的成本效益为每QALY获得5,212季度（1,428美元），每年获得3,880季度（1,063美元）。在概率敏感性分析中，在超过49％的病例中，dapagliflozin与SoC结合使用可节省成本，在超过43％的模拟病例中，针对获得的QALY和YLL具有成本效益。
■使用临床试验数据代替本地数据，这可能会限制当地的相关性。然而,缺乏来自当地卡塔尔人口的证据。此外，由于缺乏可用数据，间接成本未包括在内。
■在卡塔尔，向SoC中添加达帕格列净可能是HFrEF和无T2DM患者的一种节省成本的治疗方法。
