Cost-utility of dapagliflozin plus standard treatment compared to standard treatment for the management of heart failure with reduced ejection fraction in Colombia

Abstract

Introduction: The DAPA-HF study has shown that dapagliflozin added to standard treatment reduced the risks of worsening of heart failure or cardiovascular death compared to placebo. Objectives: To evaluate the cost- utility of dapagliflozin in combination with standard treatment compared to standard treatment alone for the treatment of heart failure with reduced ejection fraction from the perspective of the Colombian health system. Methods: A Markov model using information from the DAPA-HF study was adapted to the Colombian setting. Health states considered symptom score, and transient health states were included to assess the incidence of consultations and hospitalizations for heart failure. The time horizon was 5 years and a 5% discount rate was applied. The costs were expressed in US dollars of 2020 (1 USD =$3,693.36 COP). Results: The incremental cost-effectiveness ratio (ICER) of the intervention compared to standard treatment was USD $5,946 per quality adjusted life year gained. The ICER remained below the cost-effectiveness threshold in sub-group analyses. 97% of sensitivity analysis simulations showed an ICER below the cost-effectiveness threshold. Conclusion: From the perspective of the analysis, the addition of dapagliflozin to standard treatment is a cost-effective option in patients with heart failure with reduced ejection fraction in Colombia.