Analysis Finds Farxiga a Cost-effective Addition for Some Patients with Heart Failure

In a simulated evaluation, adding Farxiga (dapagliflozin) to guideline-directed medical therapy was projected to produce substantial clinical gains for patients with heart failure with reduced ejection fraction (HFrEF) with an acceptable increase in associated costs, according to a new study published July 27, 2021, on JAMA Network Open.

At a willingness-to-pay threshold of $100,000 per quality-adjusted life year (QALY) gained, treatment with Farxiga, at an assumed annual cost of $4,192, would be a cost-effective therapy in patients with HFrEF.

Farxiga was projected to add 0.63 QALYs at an incremental lifetime cost of $42,800, for an incremental cost-effectiveness ratio of $68,300 per QALY gained. Findings were similar in people with or without diabetes. Investigators found adding Farxiga was cost-effective in 94% of 10,000 probabilistic simulations, and they said this suggests that the findings are robust across a wide range of estimates of key model parameters.

In this analysis, investigators simulated a cohort of patients at least 66 years of age and with 41.8% who had diabetes at baseline. Median survival in the guideline-directed medical therapy arm was 6.8 years, with a range of 3.5 to 11.3 years.

Investigators’ primary outcome was incremental cost-effectiveness ratio of adding Farxiga to guideline-directed medical therapy compared with guideline-directed medical therapy for the entire cohort and stratified by baseline diabetes status.

Farxiga, developed by AstraZeneca, is a sodium-glucose cotransporter 2 (SGLT2) inhibitor approved to treat patients with type 2 diabetes, heart failure, and in April 2021 for chronic kidney disease.