The cost-effectiveness of dapagliflozin in treating high-risk patients with type 2 diabetes mellitus: an economic evaluation using data from the DECLARE-TIMI 58 trial
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Aim: To undertake a cost‐effectiveness analysis of dapagliflozin in treating high‐risk patients with type 2 diabetes mellitus (T2DM), using both directly observed events in the DECLARE‐TIMI 58 trial and surrogate risk factors to predict endpoints not captured within the trial. Methods: An established T2DM model was adapted to integrate survival curves derived from the DECLARE‐TIMI 58 trial, and extrapolated over a lifetime for all‐cause mortality, hospitalization for heart failure, stroke, myocardial infarction, hospitalization for unstable angina, and end‐stage kidney disease. The economic analysis considered the overall DECLARE trial population, as well as reported patient subgroups. Total and incremental costs, life‐years and quality‐adjusted life‐years associated with dapagliflozin versus placebo were estimated from the perspective of the UK healthcare payer. Results: In the UK setting, treatment with dapagliflozin compared to placebo was estimated to be dominant, with an expected increase in quality‐adjusted life‐years from 10.43 to 10.48 (+0.06) and a reduction in lifetime total costs from £39 451 to £36 899 (−£2552). Across all patient subgroups, dapagliflozin was estimated to be dominant, with the greatest absolute benefit in the prior heart failure subgroup (incremental lifetime costs −£4150 and quality‐adjusted life‐years +0.11). Conclusions: The results of this study demonstrate that dapagliflozin compared to placebo appears to be cost‐effective, when considering evidence reported from the DECLARE‐TIMI 58 trial, at established UK willingness‐to‐pay thresholds. The findings highlight the potential of dapagliflozin to have a meaningful impact in reducing the economic burden of T2DM and its associated complications across a broad T2DM population.
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In an analysis from the DECLARE-TIMI 58 trial, dapagliflozin treatment increased lifetime quality-adjusted life-years (QALYs) and decreased costs of healthcare at a level that met United Kingdom thresholds for cost-effectiveness due to the kidney benefits (64% of QALYs gain).
“In an analysis from the DECLARE-TIMI 58 trial, dapagli fl ozin treatment increased lifetime quality-adjusted life-years (QALYs) and decreased costs of healthcare at a level that met United Kingdom thresholds for cost-effectiveness due to the kidney bene fi ts (64% of QALYs gain).”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [138]
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- Authors
- McEwan, P., Morgan, A. R., Boyce, R., Bergenheim, K., Gause‐Nilsson, I. A. M., Bhatt, D. L., Leiter, L. A., Johansson, P. A., Mosenzon, O., Cahn, A., & Wilding, J. P. H.
- Affiliations
- Health Economics and Outcomes Research (United Kingdom) (GB)
- AstraZeneca (Sweden) (SE)
- Brigham and Women's Hospital (US)
- St. Michael's Hospital (CA)
- Hebrew University of Jerusalem (IL)
- University of Liverpool (GB)
- Corresponding author
- McEwan, Phil
- ORCID
- Venue
- Diabetes, Obesity and Metabolism
- Publisher
- Wiley
- Published
- 2021-01-25
- Volume
- 23
- Issue
- 4
- Pages
- 1020-1029
- ISSN
- 1462-8902 (ISSN-L)
- 1463-1326
- PMC
- PMC8048502
- OpenAlex
- W3116633224
- Cited by
- 34
- References
- 56
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 2 · 2022: 16 · 2021: 3 · 2020: 1
- FWCI
- 4.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Obesity and Metabolism (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- AstraZeneca
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- dapagliflozin, type 2 diabetes, cost-effectiveness, SGLT2 inhibitors, heart failure, myocardial infarction, stroke, end-stage renal disease, quality-adjusted life years, lifetime costs, surrogate endpoints, economic models
- MeSH terms
- Benzhydryl Compounds, Cost-Benefit Analysis, Diabetes Mellitus, Type 2, Glucosides, Humans
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