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

Farmeconomia. Health economics and therapeutic pathways

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Title 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
 
Creator Iannazzo, Sergio
Mannucci, Edoardo
Reifsnider, Odette
Maggioni, Aldo Pietro
 
Subject
Cost-effectiveness; Cost-utility; Type 2 diabetes; Cardiovascular risk; Empagliflozin; EMPA-REG OUTCOME
 
Description INTRODUCTION: The EMPA-REG OUTCOME trial demonstrated the efficacy of empagliflozin in the treatment of type 2 diabetes (T2D) with a previous history of cardiovascular (CV) disease. The drug is currently reimbursed for T2D Italian patients, but the reduction of CV mortality and morbidity shown in the trial opens a new treatment perspective in those patients with associated high CV risk.OBJECTIVE: Cost-effectiveness analysis of empagliflozin for the treatment of T2D patients with a previous history of CV disease, from the Italian National Health Service (NHS) perspective.METHODS: The analysis was performed with an individual simulation model, which can predict the time to CV events or death through a set of time-dependent regressions estimated on the patient-level data of the EMPA-REG OUTCOME trial. This design allows the direct simulation of long-term outcomes and costs without the need for surrogate endpoints.The model was adapted to the Italian setting, considering local epidemiological data, baseline quality of life (QoL) utility, background mortality and unit costs from current prices and tariffs. The cost perspective was that of the Italian NHS and the horizon of the simulation was lifetime. Costs and benefits were discounted at a 3.5% rate.RESULTS: Base case results were estimated on a cohort of 5,000 patients, which ensured the convergence of the simulation. Patients treated with empagliflozin in add-on to the standard of care (SoC) lived on the average 13.8 undiscounted years as compared to 11.8 years of patients on SoC alone. The gain in discounted quality-adjusted life years (QALYs) was 1.0, due to improved survival and QoL linked to the reduced incidence of CV events and CV mortality. The incremental cost-effectiveness ratio (ICER) was 4,811 €/QALY, well below the commonly applied threshold of 30,000-50,000 €/QALY.CONCLUSION: Empagliflozin in add-on to the SoC is a highly cost-effective strategy for the treatment of T2D patients with known CV disease in the Italian setting.
 
Publisher SEEd Medical Publishers
 
Contributor
 
Date 2017-10-05
 
Type info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion

 
Format text/html
application/pdf
 
Identifier https://journals.edizioniseed.it/index.php/FE/article/view/1332
10.7175/fe.v18i1.1332
 
Source Farmeconomia. Health economics and therapeutic pathways; Vol 18, No 1 (2017)
2240-256X
 
Language eng
 
Relation https://journals.edizioniseed.it/index.php/FE/article/view/1332/1653
https://journals.edizioniseed.it/index.php/FE/article/view/1332/1654
 
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Rights Copyright (c) 2017 Farmeconomia. Health economics and therapeutic pathways
http://creativecommons.org/licenses/by-nc/4.0
 

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