Heart failure & cardiomyopathiesMeta-analysis
Cost-Effectiveness of Sodium-Glucose Co-Transporter-2 Inhibitors and Angiotensin Receptor-Neprilysin Inhibitors by Ejection Fraction and Drug Pricing in the United States: A Systematic Review
- Systematic Review
Authors' conclusion
At negotiated prices resulting from the Inflation Reduction Act, SGLT2 inhibitors and ARNIs seem cost-effective in HFrEF, with projected cost-effectiveness in HFmrEF/HFpEF dependent on price reductions and less certain treatment-effect estimates.
Study context
- Population
- Cost-effectiveness analyses of SGLT2 inhibitors and angiotensin receptor-neprilysin inhibitors (ARNIs) versus standard of care for the treatment of heart failure (HF) from a US perspective, published through 2025studies included of 821 identified · HFrEF 11 · HFrEF/HFmrEF/HFpEF 2 · HFmrEF/HFpEF 3
- Participants
- 16 participants
- Comparison
- SGLT2 inhibitors and ARNIs versus standard of care
Pooled result
As reported in the abstract
SGLT2 inhibitors
$59 600 to $187 100/quality-adjusted life year (QALY) gained
range
ARNIs
$24 400 to $92 300
range
SGLT2 inhibitors + ARNIs
$69 300 to $91 500
range
Further pooled results
| Outcome | SGLT2 inhibitors | ARNIs | SGLT2 inhibitors + ARNIs | standard of care |
|---|---|---|---|---|
| Incremental cost-effectiveness ratio at negotiated drug prices, across all EF categories | $47 800/QALY gained | $39 900/QALY gained | $44 400/QALY gained | Not reported in the abstract |
Incremental cost-effectiveness ratios by ejection fraction (EF)
- HFrEF studies
- <$120 000/QALY gained
- HFmrEF/HFpEF studies, all but 1
- ≥$120 000/QALY gained
Key drivers of cost-effectiveness
- drug price
- 17 studies
- cardiovascular death risk with SGLT2 inhibitors and ARNIs
- 15 studies
- duration of intervention effectiveness
- 5 studies
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Summarised from the published abstract; every number is checked against it