Model-based predictions on health benefits and budget impact of implementing empagliflozin in people with type 2 diabetes and established cardiovascular disease
Nilsson, Kristoffer ; Andersson, Emelie ; Persson, Sofie LU ; Karlsdotter, Kristina LU ; Skogsberg, Josefin ; Gustavsson, Staffan ; Jendle, Johan and Steen Carlsson, Katarina LU
(2023)
In Diabetes, Obesity and Metabolism
25(3).
p.748-757
- Abstract
Aim: To perform a model-based analysis of the short- and long-term health benefits and costs of further increased implementation of empagliflozin for people with type 2 diabetes and established cardiovascular disease (eCVD) in Sweden. Materials and Methods: The validated Institute for Health Economics Diabetes Cohort Model (IHE-DCM) was used to estimate health benefits and a 3-year budget impact, and lifetime costs per quality-adjusted life years (QALY) gained of increased implementation of adding empagliflozin to standard of care (SoC) for people with type 2 diabetes and eCVD in a Swedish setting. Scenarios with 100%/75%/50% implementation were explored. Analyses were based on 30 model cohorts with type 2 diabetes and eCVD (n = 131 412... (More)
Aim: To perform a model-based analysis of the short- and long-term health benefits and costs of further increased implementation of empagliflozin for people with type 2 diabetes and established cardiovascular disease (eCVD) in Sweden. Materials and Methods: The validated Institute for Health Economics Diabetes Cohort Model (IHE-DCM) was used to estimate health benefits and a 3-year budget impact, and lifetime costs per quality-adjusted life years (QALY) gained of increased implementation of adding empagliflozin to standard of care (SoC) for people with type 2 diabetes and eCVD in a Swedish setting. Scenarios with 100%/75%/50% implementation were explored. Analyses were based on 30 model cohorts with type 2 diabetes and eCVD (n = 131 412 at baseline) from national health data registers. Sensitivity analyses explored the robustness of results. Results: Over 3 years, SoC with empagliflozin (100% implementation) versus SoC before empagliflozin resulted in 7700 total life years gained and reductions in cumulative incidence of cardiovascular deaths by 30% and heart failures by 28%. Annual costs increased by 15% from higher treatment costs and increased survival. Half of these benefits and costs are not yet reached with current implementation below 50%. SoC with empagliflozin yielded 0.37 QALYs per person, with an incremental cost-effectiveness ratio of 16 000 EUR per QALY versus SoC before empagliflozin. Conclusions: Model simulations using real-world data and trial treatment effects indicated that a broader implementation of empagliflozin, in line with current guidelines for treatment of people with type 2 diabetes and eCVD, would lead to further benefits even from a short-term perspective.
(Less)
- author
- Nilsson, Kristoffer
; Andersson, Emelie
; Persson, Sofie
LU
; Karlsdotter, Kristina
LU
; Skogsberg, Josefin
; Gustavsson, Staffan
; Jendle, Johan
and Steen Carlsson, Katarina
LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Diabetes, Obesity and Metabolism
- volume
- 25
- issue
- 3
- pages
- 748 - 757
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:36371543
- scopus:85143532312
- ISSN
- 1462-8902
- DOI
- 10.1111/dom.14921
- language
- English
- LU publication?
- yes
- id
- 1c4b9a3a-5abc-4162-b9c7-8530e8627b2e
- date added to LUP
- 2023-01-30 10:46:31
- date last changed
- 2024-09-15 20:47:54
@article{1c4b9a3a-5abc-4162-b9c7-8530e8627b2e,
abstract = {{<p>Aim: To perform a model-based analysis of the short- and long-term health benefits and costs of further increased implementation of empagliflozin for people with type 2 diabetes and established cardiovascular disease (eCVD) in Sweden. Materials and Methods: The validated Institute for Health Economics Diabetes Cohort Model (IHE-DCM) was used to estimate health benefits and a 3-year budget impact, and lifetime costs per quality-adjusted life years (QALY) gained of increased implementation of adding empagliflozin to standard of care (SoC) for people with type 2 diabetes and eCVD in a Swedish setting. Scenarios with 100%/75%/50% implementation were explored. Analyses were based on 30 model cohorts with type 2 diabetes and eCVD (n = 131 412 at baseline) from national health data registers. Sensitivity analyses explored the robustness of results. Results: Over 3 years, SoC with empagliflozin (100% implementation) versus SoC before empagliflozin resulted in 7700 total life years gained and reductions in cumulative incidence of cardiovascular deaths by 30% and heart failures by 28%. Annual costs increased by 15% from higher treatment costs and increased survival. Half of these benefits and costs are not yet reached with current implementation below 50%. SoC with empagliflozin yielded 0.37 QALYs per person, with an incremental cost-effectiveness ratio of 16 000 EUR per QALY versus SoC before empagliflozin. Conclusions: Model simulations using real-world data and trial treatment effects indicated that a broader implementation of empagliflozin, in line with current guidelines for treatment of people with type 2 diabetes and eCVD, would lead to further benefits even from a short-term perspective.</p>}},
author = {{Nilsson, Kristoffer and Andersson, Emelie and Persson, Sofie and Karlsdotter, Kristina and Skogsberg, Josefin and Gustavsson, Staffan and Jendle, Johan and Steen Carlsson, Katarina}},
issn = {{1462-8902}},
language = {{eng}},
number = {{3}},
pages = {{748--757}},
publisher = {{Wiley-Blackwell}},
series = {{Diabetes, Obesity and Metabolism}},
title = {{Model-based predictions on health benefits and budget impact of implementing empagliflozin in people with type 2 diabetes and established cardiovascular disease}},
url = {{http://dx.doi.org/10.1111/dom.14921}},
doi = {{10.1111/dom.14921}},
volume = {{25}},
year = {{2023}},
}