Evidence map›Paper›PMID 34627231›Full record

ArticleCardiovascular diabetology2021

Cost-effectiveness evaluation of add-on dapagliflozin for heart failure with reduced ejection fraction from perspective of healthcare systems in Asia-Pacific region.

Chia-Te Liao, Chun-Ting Yang, Han Siong Toh, Wei-Ting Chang, Hung-Yu Chang, Fang-Hsiu Kuo, Mei-Chuan Lee, Yi-Ming Hua, Hsin-Ju Tang, Carol Strong and 1 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cardiovascular diabetology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 4 pooled it
2.8field-weighted citation impact, top 8% of its field
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

14 citing papers in PubMed, 4 syntheses or guidelines pooled it, 26 citations in OpenAlex.

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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

11 authors at 4 institutions in 1 country.

Chia-Te Liao *Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Chun-Ting Yang *Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Han Siong TohDepartment of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Wei-Ting ChangDivision of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Hung-Yu ChangHeart Center, Cheng Hsin General Hospital, Taipei, Taiwan.
Fang-Hsiu KuoDivision of Cardiology, Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
Mei-Chuan LeeDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Yi-Ming HuaDepartment of Pharmacy, Chi Mei Medical Center, Tainan, Taiwan.
Hsin-Ju TangDepartment of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.
Carol StrongDepartment of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Huang-Tz OuInstitute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. huangtz@mail.ncku.edu.tw.ORCID 0000-0002-5475-7848
Chi Mei Medical Center · TWNational Cheng Kung University · TWChang Gung University of Science and Technology · TWNational Yang Ming Chiao Tung University · TW

Funding

ministry of science and technology, taiwan 109-2320-B-006 -047-MY3
6 · The paper itself

Abstract

backgroundWith emerging evidence on the efficacy of adding dapagliflozin to standard care for patients with heart failure with reduced ejection fraction (HFrEF), this study assessed the cost-effectiveness of add-on dapagliflozin to standard care versus standard care alone for HFrEF from the perspective of healthcare systems in the Asia-Pacific region.

methodsA Markov model was applied to project the outcomes of treatment in terms of lifetime medical cost and quality-adjusted life-years. The transition probabilities between health states in the model were obtained from the Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction trial. Country-specific costs and utilities were extracted for modeling. The incremental cost-effectiveness ratio against a country-specific willingness-to-pay threshold was applied to determine the cost-effectiveness of treatment. A series of sensitivity analyses were performed to ensure the robustness of the study results. Costs are presented in 2020 United States dollars.

resultsThe incremental cost-effectiveness ratios for add-on dapagliflozin versus standard care alone were $5277, $9980, $12,305, $16,705, and $23,227 per quality-adjusted life-year gained in Korea, Australia, Taiwan, Japan, and Singapore, respectively. When using add-on dapagliflozin to standard care versus standard care alone, ~ 100% of simulations were cost-effective at a willingness-to-pay threshold of one gross domestic product per capita of the given Asia-Pacific country; however, the probability of being cost-effective for using add-on dapagliflozin decreased when the time horizon for simulation was restricted to 18 months and when the cardiovascular mortality for the two treatments (43.8% and 33.0%, respectively) was assumed to be the same. The cost-effectiveness results were most sensitive to cardiovascular mortality of treatment.

conclusionsAdding dapagliflozin to standard care is cost-effective for HFrEF in healthcare systems in the Asia-Pacific region, which supports the rational use of dapagliflozin for HFrEF in this region.

Indexed as

Drug CostsAgedAsiaAustraliaBenzhydryl CompoundsCost-Benefit AnalysisDelivery of Health CareFemaleGlucosidesHeart Failure, SystolicHospital CostsHospitalizationHumansMaleMarkov ChainsModels, EconomicBenzhydryl CompoundsdapagliflozinGlucosidesSodium-Glucose Transporter 2 InhibitorsCost-effectivenessDapagliflozinHeart failure

Identifiers

PMID34627231
PMCPMC8502298
OpenAlexW3207947340

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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 OpenQuestion graph.