Heart failure & cardiomyopathies
Empagliflozin Cost-Effectiveness Analysis in Japanese Heart Failure with Mildly Reduced and Preserved Ejection Fraction
Authors' conclusion
Empagliflozin was demonstrated to be cost-effective for patients with HFpEF in Japan based on EMPEROR-Preserved trial data.
Study context
- Population
- Japanese patients with heart failure with preserved ejection fraction (HFpEF)Markov cohort model
- Exposure
- Empagliflozin + standard of care (SoC) vs SoC alone
- Outcome
- ICER (cost per QALY)
- Follow-up
- Lifetime horizon
Methodological detailsMarkov cohort model, Japanese healthcare system perspective, lifetime horizon, inputs from EMPEROR-Preserved trial data, a claims database and published literature
- Markov cohort model
- Japanese healthcare system perspective
- Lifetime horizon
- Inputs from EMPEROR-Preserved trial data, a claims database and published literature
Main finding
As reported in the abstract
Cost-effectiveness (base case, lifetime horizon, Japanese healthcare system perspective)
Incremental quality-adjusted life years (QALYs)
0.11 QALYs
Empagliflozin + SoC
Incremental life years
0.08 life years
Empagliflozin + SoC
- Incremental cost-effectiveness ratio (ICER) (empagliflozin + SoC vs SoC alone), below Japanese willingness-to-pay (WTP) threshold of $38 408 (¥5 000 000)/QALY
- $12 772 (¥1 662 689)/QALY
Observational data: associations, not effects.
Further findings
Subgroups (age, body mass index (BMI), region Asia, NYHA class)
- Lowest ICER of remaining subgroups (baseline age ≥ 75 years)
- $7520/QALY (¥978 972/QALY)
- Highest ICER of remaining subgroups (baseline NYHA class III/IV)
- $31 049/QALY (¥4 041 896/QALY)
- Results consistent across all subgroups; empagliflozin dominant in region Asia and BMI < 25 kg/m² subgroups
Deterministic sensitivity analysis
- Treatment effect on hospitalization for heart failure (HHF) is the biggest driver; ICER still under threshold even if no effect on HHF assumed
Probabilistic sensitivity analysis
- Simulations cost-effective at Japanese WTP threshold
- 64%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Empagliflozin Cost-Effectiveness Analysis in Japanese Heart Failure with Mildly Reduced and Preserved Ejection Fraction. ESC Heart Fail. Published 15 November 2023. doi:10.
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