Cause-Specific Health Care Costs Following Hospitalization for Heart Failure and Cost Offset With SGLT2i Therapy

Area of Science:

• Cardiovascular Medicine
• Health Economics
• Pharmacoeconomics

Background:

• Limited understanding of cause-specific healthcare costs in heart failure (HF) based on ejection fraction (EF) ≤40% versus >40%.
• Uncertainty regarding the potential cost-saving implications of sodium glucose co-transporter 2 inhibitor (SGLT2i) therapy in HF patients.

Purpose of the Study:

• To compare cause-specific healthcare costs in patients hospitalized for HF with EF ≤40% versus EF >40%.
• To estimate the potential cost offset associated with the implementation of SGLT2i therapy in eligible HF patients.

Main Methods:

• Analysis of Medicare beneficiaries hospitalized for HF (2016-2020) from the Get With The Guidelines-Heart Failure registry.
• Calculation and comparison of mean per-patient total and cause-specific costs from discharge through 1-year follow-up between EF groups.
• Meta-analysis of 5 pivotal SGLT2i trials to estimate risk reductions in all-cause and HF hospitalizations, applied to Medicare beneficiaries to project cost offsets (excluding drug costs).

Main Results:

• Among 146,003 patients, total 1-year costs averaged $40,557, with similar overall costs between EF groups.
• Patients with EF ≤40% had higher costs among survivors; patients with EF >40% incurred higher costs from non-HF/non-CV hospitalizations and skilled nursing facilities.
• SGLT2i therapy demonstrated significant relative risk reductions of 11% for all-cause and 29% for HF hospitalizations, irrespective of EF, projecting annual cost reductions of $1,439-$2,668 per patient.

Conclusions:

• Cause-specific healthcare costs differ between HF patients with EF ≤40% and EF >40%.
• SGLT2i therapy significantly reduces HF and all-cause hospitalization rates, regardless of EF.
• Implementation of SGLT2i therapy is projected to yield substantial cost savings post-discharge, ranging from $1,439 to $2,668 per patient annually (excluding drug costs).