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Cost-Effectiveness of Sotagliflozin in SOLOIST-WHF
William S Weintraub1, Paul Kolm2, Sarahfaye Dolman2
1MedStar Health Research Institute, Washington, DC, USA; Department of Medicine, Georgetown University, Washington, DC, USA.
Insights
Sotagliflozin is cost-effective for patients with diabetes and heart failure, offering improved quality-adjusted life-years. This analysis provides valuable economic insights for treatment decisions in heart failure management.
Area of Science:
- Pharmacoeconomics
- Cardiovascular Medicine
- Diabetes Management
Background:
- The SOLOIST-WHF trial demonstrated sotagliflozin's efficacy in diabetes patients with recent heart failure worsening.
- Cost-effectiveness of sotagliflozin in this population remained uninvestigated.
Purpose of the Study:
- To determine the cost-effectiveness of sotagliflozin for patients with diabetes and recent worsening of heart failure.
- Evaluate the economic value of sotagliflozin in a U.S. healthcare context.
Main Methods:
- A Markov model was developed using data from the SOLOIST-WHF trial (N=1,222).
- Lifetime costs and quality-adjusted life-years (QALYs) were estimated from a U.S. healthcare sector perspective.
- Cost data were sourced from the National Inpatient Sample, with utility assessed from published reports.
Main Results:
- Sotagliflozin yielded higher lifetime QALYs (4.43 vs. 4.04) and costs ($220,113 vs. $188,198) compared to placebo.
- The incremental cost-effectiveness ratio was $81,823 per QALY gained.
- Cost-effectiveness probability reached 67.5% and 89.4% at willingness-to-pay thresholds of $100,000 and $150,000, respectively.
Conclusions:
- Sotagliflozin is considered cost-effective in the U.S. for patients with diabetes and recent heart failure worsening.
- The findings support sotagliflozin's use within commonly accepted willingness-to-pay thresholds for heart failure treatment.
Background:
The efficacy of sotagliflozin in patients with diabetes and recent worsening of heart failure was shown in the SOLOIST-WHF trial. However, the cost-effectiveness of sotagliflozin in these patients has not been previously investigated.
Objectives:
The authors sought to determine the cost-effectiveness of sotagliflozin in patients with diabetes and recent worsening of heart failure.
Methods:
Based on SOLOIST-WHF trial data (N = 1,222), the authors constructed a Markov model to estimate the lifetime impact of sotagliflozin from a U.S. health care sector perspective. Cost data were sourced from the National Inpatient Sample. Life expectancy was modeled from census data and modified by the mortality rate in SOLOIST-WHF. Fatal and nonfatal event rates were carried forward from the trial data. Utility was assessed from the published reports.
Results:
Lifetime quality-adjusted life-years (QALYs) were 4.43 and 4.04 in the sotagliflozin and placebo groups, respectively, and lifetime costs were $220,113 and $188,198 in the sotagliflozin and placebo groups, respectively. The point estimate incremental cost-effectiveness ratio was $81,823 per QALY gained. The probability of being cost-effective was 3.6%, 67.5%, and 89.4% at willingness-to-pay thresholds of $50,000, $100,000, and $150,000, respectively, per QALY gained.
Conclusions:
In patients with diabetes and recent worsening of heart failure, sotagliflozin is cost-effective in the U.S. using commonly accepted willingness-to-pay thresholds. (Effect of Sotagliflozin on Cardiovascular Events in Participants With Type 2 Diabetes Post Worsening Heart Failure [SOLOIST-WHF]; NCT03521934).
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