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Published on: June 10, 2025
Trends in Healthcare Costs in Heart Failure and Its Clinical Phenotypes During the Implementation of SGLT2
Johan Liseth Hansen1,2, Miikka Tarkia3, Marija Vasilevska1
1Quantify Research, Stockholm, Sweden.
Insights
Early use of SGLT2 inhibitors in heart failure patients was associated with lower healthcare costs, primarily due to reduced hospitalizations. This suggests economic benefits for SGLT2 inhibitor initiation in heart failure management.
Area of Science:
- Cardiology
- Pharmacoeconomics
- Real-world evidence
Background:
- Limited real-world data exists on healthcare costs associated with SGLT2 inhibitor use in heart failure (HF) patients.
- Understanding these costs across different HF phenotypes (HFrEF, HFmrEF, HFpEF) is crucial for early adoption.
- This study aims to analyze healthcare resource utilization (HCRU) and costs in HF patients based on SGLT2 inhibitor use.
Purpose of the Study:
- To assess healthcare resource utilization (HCRU) and associated costs among heart failure (HF) patients.
- To stratify analysis by SGLT2 inhibitor use and left ventricular ejection fraction (LVEF) phenotypes.
- To evaluate trends in HCRU and costs during the early adoption phase of SGLT2 inhibitors.
Main Methods:
- Utilized Finnish specialty care registry data for adult patients with a first HF diagnosis (Jan 2016 - Jun 2022).
- Categorized patients by LVEF: reduced (HFrEF), mildly reduced (HFmrEF), and preserved (HFpEF).
- Assessed annual SGLT2 inhibitor uptake (2016-2022) and stratified patients by use within 365 days of diagnosis to analyze HCRU and costs (2016-2021).
Main Results:
- SGLT2 inhibitor initiation occurred in 6.4% of 119,314 HF patients within one year; uptake in HFrEF rose from 14.4% (2020) to 50.1% (2022).
- SGLT2 inhibitor users were younger, more often male, and had higher type 2 diabetes prevalence.
- Total annual HCRU costs were lower for SGLT2 inhibitor users (€30,742 vs €34,235 in 2021), driven by reduced inpatient admissions (shorter stays and fewer admissions).
Conclusions:
- SGLT2 inhibitor uptake significantly increased post-regulatory approvals.
- Patients using SGLT2 inhibitors demonstrated lower healthcare costs, mainly due to decreased hospitalization expenses.
- Early SGLT2 inhibitor initiation in HF management shows potential economic benefits, warranting further long-term cost-effectiveness research.
Purpose:
Real-world data on healthcare costs associated with SGLT2 inhibitor use during its early adoption remains limited, particularly across heart failure (HF) phenotypes. This study assessed trends in healthcare resource utilization (HCRU) and costs among HF patients, stratified by SGLT2 inhibitor use and left ventricular ejection fraction (LVEF).
Patients And Methods:
Using Finnish specialty care registry data, adults with a first HF diagnosis between January 1, 2016, and June 30, 2022 were identified and categorized by LVEF as reduced (HFrEF), mildly reduced (HFmrEF), and preserved (HFpEF) LVEF. Annual SGLT2 inhibitor uptake (2016-2022) was assessed. Patients were stratified by SGLT2 inhibitor use within 365 days of HF diagnosis to assess HCRU and costs trends (2016-2021).
Results:
Among 119,314 patients, 7,626 (6.4%) initiated SGLT2 inhibitors within a year. Among those with LVEF data (n=16,312/119,314 [13.7%]), HFpEF predominated (58%). SGLT2 inhibitor use in HFrEF increased from 14.4% (2020) to 50.1% (2022). Patients receiving SGLT2 inhibitors were younger (70.8 vs 78.6 years), more often male (65.0% vs 47.2%), and had higher prevalence of type 2 diabetes (72.4% vs 28.5%) compared with those without SGLT2 inhibitor use. From 2016 to 2021, inpatient admissions declined modestly across all groups, with consistently shorter stays among patients with SGLT2 inhibitors compared with those not using them (mean: 20.0 vs 26.3 days [2016]; 17.2 vs 21.7 days [2021]). Outpatient visits and drug dispensations were higher in the SGLT2 inhibitor group. Total annual HCRU costs declined over time, remaining lower for SGLT2 inhibitor users (€30,742 vs €34,235 in 2021), driven by reduced inpatient admission costs.
Conclusion:
SGLT2 inhibitor uptake increased notably following regulatory approvals. Patients who received SGLT2 inhibitors had lower healthcare costs driven by reduced hospitalization costs, suggesting economic benefits of early SGLT2 inhibitor initiation in HF management and supporting further research evaluation of long-term cost-effectiveness.
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