Table 2. Base Case Results.
| Characteristic | All patients | No diabetes | Diabetes | |||
|---|---|---|---|---|---|---|
| GDMT | Dapagliflozin | GDMT | Dapagliflozin | GDMT | Dapagliflozin | |
| Health outcomes | ||||||
| Survival, life-years (undiscounted) | 6.82 (6.77-6.86) | 7.73 (7.10-7.76) | 7.60 (7.51-7.68) | 8.42 (7.57-9.28) | 5.73 (5.38-6.13) | 6.77 (5.59-8.18) |
| Survival, life-years (discounted) | 5.91 (5.87-5.91) | 6.6 (6.13-7.10) | 6.52 (6.46-6.57) | 7.12 (6.48-7.77) | 5.07 (4.79-5.39) | 5.88 (4.96-6.96) |
| Incremental life years (discounted) | [Reference] | 0.64 (0.21-1.11) | [Reference] | 0.61 (0.18-1.13) | [Reference] | 0.81 (0.22-1.45) |
| QALYs (discounted) | 4.73 (4.69-4.76) | 5.36 (4.98-5.76) | 5.28 (5.23-5.33) | 5.86 (5.33-6.38) | 3.96 (3.77-4.24) | 4.66 (3.96-5.56) |
| Incremental QALYs (discounted) | [Reference] | 0.63 (0.25-0.94) | [Reference] | 0.58 (0.21-0.98) | [Reference] | 0.70 (0.23-1.20) |
| evLYGa | [Reference] | 0.76 (0.29-1.26) | [Reference] | 0.69 (0.04-1.31) | [Reference] | 0.87 (0.28-1.51) |
| Direct health care costs, $b | ||||||
| Lifetime health care costs (discounted) | 150 600 (131 300-172 200) | 193 400 (168 400-222 500) | 148 900 (126 000-174 700) | 189 000 (158 800-224 400) | 152 900 (126 000-174 700) | 199 400 (163 400-224 400) |
| Spending on dapagliflozin | NA | 27 700 (25 700-29 800) | NA | 29 900 (27 200-32 600) | NA | 24 700 (22 200-27 300) |
| Spending on HF hospitalizations | 6900 (5200-9200) | 5400 (3900-7500) | 6600 (4900-8800) | 4600 (3200-6600) | 7300 (5500-9800) | 6500 (4500-9300) |
| Incremental health costs (discounted) | [Reference] | 42 800 (37 100-50 300) | [Reference] | 40 100 (32 700-49 700) | [Reference] | 46 500 (32 700-49 700) |
| ICER, $ | ||||||
| Per life-year gained | [Reference] | 61 800 (47 500 131 700) | [Reference] | 66 200 (45 000-dominated) | [Reference] | 57 300 (44 800-123 800) |
| Per QALY gained | [Reference] | 68 300 (54 600-117 600) | [Reference] | 69 600 (50 700-445 700) | [Reference] | 66 800 (53 800-116 600) |
| Per evLYGa | [Reference] | 56 100 (44 700-100 700) | [Reference] | 58 500 (42 300-315 600) | [Reference] | 53 400 (42 800-97 200) |
Abbreviations: evLYG, equal value of life-years gained; GDMT, guideline-directed medical therapy; HF, heart failure; ICER, incremental cost-effectiveness ratio; NA, not applicable; QALY, quality-adjusted life-year; UI, uncertainty interval.
a
As the use of QALYs may undervalue prolonged survival among individuals with imperfect quality-of-life at baseline, we also computed the incremental cost evLYG, an approach that assumes that any extension of life has a perfect quality-of-life.36
b
In 2020 US dollars.