Table 3.
Cost-effectiveness of each DCS sub-cohorts (in 2021, euro, Dutch unit costs, Dutch setting, 40 years)
| Scenario 1 (base case) | Scenario 2 (worst case) | Scenario 3 (best case) | Scenario 4 (no HR) | |
|---|---|---|---|---|
| Trial-based cohorts | ||||
| Canagliflozin (DCS-CANVAS) | ||||
| ∆QALY | 1.07 | 0.50 | 1.58 | 0.33 |
| ∆Cost | 5735 | 2330 | 10,057 | 1324 |
| ICER | 5382 | 4630 | 6376 | 3987 |
| Dapagliflozin (DCS-DECLARE) | ||||
| ∆QALY | 0.94 | 0.36 | 2.03 | 0.24 |
| ∆Cost | 4720 | 1980 | 12,298 | 1583 |
| ICER | 5001 | 5454 | 6045 | 6476 |
| Empagliflozin (DCS-EMPA) | ||||
| ∆QALY | 1.04 | 0.50 | 1.21 | 0.20 |
| ∆Cost | 8150 | 3884 | 9529 | 1505 |
| ICER | 7822 | 7782 | 7859 | 7538 |
| Reimbursed cohort (DCS-ZIN) | ||||
| Canagliflozin | ||||
| ∆QALY | 1.13 | 0.44 | 2.00 | 0.16 |
| ∆Cost | 6226 | 3003 | 12,404 | 1796 |
| ICER | 5495 | 6779 | 6192 | 11,509 |
| Dapagliflozin | ||||
| ∆QALY | 0.99 | 0.29 | 2.31 | 0.14 |
| ∆Cost | 5410 | 2371 | 13,880 | 1788 |
| ICER | 5476 | 8229 | 6007 | 12,839 |
| Empagliflozin | ||||
| ∆QALY | 1.26 | 0.53 | 1.50 | 0.16 |
| ∆Cost | 6698 | 3413 | 7838 | 1776 |
| ICER | 5320 | 6447 | 5228 | 11,303 |
| Weighted average of trials | ||||
| ∆QALY | 0.96 | 0.35 | 1.72 | 0.15 |
| ∆Cost | 5235 | 2591 | 10,089 | 1814 |
| ICER | 5440 | 7411 | 5870 | 11,902 |
| RWE of SGLT2i | ||||
| ∆QALY | 2.69 | 0.91 | 3.84 | 0.15 |
| ∆Cost | 13,124 | 4908 | 19,960 | 1814 |
| ICER | 4873 | 5390 | 5196 | 11,902 |
| For potential users in GP practice (using treatment effect from weighted average of trials) | ||||
| ∆QALY | 1.06 | 0.43 | 1.54 | 0.26 |
| ∆Cost | 4796 | 2221 | 7425 | 1591 |
| ICER | 4530 | 5190 | 4818 | 6035 |
| For potential users in GP practice (using treatment effect from RWE) | ||||
| ∆QALY | 2.45 | 0.85 | 3.65 | 0.26 |
| ∆Cost | 10,053 | 3742 | 16,699 | 1591 |
| ICER | 4098 | 4421 | 4577 | 6035 |
∆QALY incremental quality adjusted life years comparing SGLT2i to care-as-usual, ∆Cost incremental costs comparing SGLT2i to care-as-usual, DCS-CANVAS the subset of Hoorn Diabetes Care System cohort filtered by CANagliflozin cardioVascular Assessment Study [7], DCS-DECLARE the subset of Hoorn Diabetes Care System cohort filtered by Multicenter Trial to Evaluate the Effect of Dapagliflozin on the Incidence of Cardiovascular Events [8], DCS-EMPA the subset of Hoorn Diabetes Care System cohort filtered by Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patient [6], DCS-ZIN the subset of Hoorn Diabetes Care System cohort filtered by Dutch reimbursement criteria (version October 2022 [25]), GP general practitioner, HR hazard ratios, ICER incremental cost-effectiveness ratio, RWE real-world evidence, SGLT2i sodium–glucose cotransporter 2 inhibitors