Cost-effectiveness analysis of empagliflozin in the treatment of patients with type 2 diabetes and established cardiovascular disease in Italy, based on the results of the EMPA-REG OUTCOME study

• DOI: 10.7175/fe.v18i1.1332
• Publication Date: 2017-10-05T13:09:51Z
• Authors: Sergio Iannazzo; Edoardo Mannucci; Odette Reifsnider; Aldo Pietro Maggioni
• Keywords: Empagliflozin; EMPA

INTRODUCTION: The EMPA-REG OUTCOME trial demonstrated the efficacy of empagliflozin in treatment type 2 diabetes (T2D) with a previous history cardiovascular (CV) disease. drug is currently reimbursed for T2D Italian patients, but reduction CV mortality and morbidity shown opens new perspective those patients associated high risk.OBJECTIVE: Cost-effectiveness analysis disease, from National Health Service (NHS) perspective.METHODS: was performed an individual simulation model, which can predict time to events or death through set time-dependent regressions estimated on patient-level data trial. This design allows direct long-term outcomes costs without need surrogate endpoints.The model adapted setting, considering local epidemiological data, baseline quality life (QoL) utility, background unit current prices tariffs. cost that NHS horizon lifetime. Costs benefits were discounted at 3.5% rate.RESULTS: Base case results cohort 5,000 ensured convergence simulation. Patients treated add-on standard care (SoC) lived average 13.8 undiscounted years as compared 11.8 SoC alone. gain quality-adjusted (QALYs) 1.0, due improved survival QoL linked reduced incidence mortality. incremental cost-effectiveness ratio (ICER) 4,811 €/QALY, well below commonly applied threshold 30,000-50,000 €/QALY.CONCLUSION: Empagliflozin highly cost-effective strategy known disease setting.