Kishi Takuya, Kunikane Eriko, Takagi Hiroyuki, Chen Jieling, Varela Luis, Ozaki Asuka
Department of Graduate School of Medicine (Cardiology), International University of Health and Welfare Fukuoka Japan.
Cardiovascular, Renal and Metabolism, BioPharmaceuticals Medical Affairs, AstraZeneca K.K. Osaka Japan.
Circ Rep. 2025 Apr 12;7(6):426-432. doi: 10.1253/circrep.CR-25-0022. eCollection 2025 Jun 10.
Dapagliflozin is clinically beneficial in heart failure (HF). However, how these clinical benefits translate into economic burden reduction is unclear. With IMPLICATION HF, we projected the reductions in HF events and costs that would result from dapagliflozin use in Japan using a cost offset model.
The modeled population comprised symptomatic HF patients from the DAPA-HF and DELIVER trials. We compared the event incidences and associated costs between HF treatment with and without dapagliflozin, using the prevalence, event rates, and event costs of HF in Japan from published literature, as well as the treatment effects of dapagliflozin from the pooled meta-analysis of DAPA-HF and DELIVER. The cumulative number of events (HF hospitalization [hHF], cardiovascular [CV] death, and all-cause death) and associated costs (hHF, CV death, total) were projected. Cost offsets were calculated according to the difference in event-related costs between HF treatment with and without dapagliflozin. Dapagliflozin was estimated to prevent 63,770 hHF events (number needed to treat [NNT] 20), 11,613 CV deaths (NNT 108), and 16,141 all-cause deaths (NNT 78), as well as reducing hHF and CV death costs by JPY62.7 billion and JPY16.6 billion, totaling JPY79.3 billion over 1 year in Japan. The sensitivity analyses corroborated these findings.
The addition of dapagliflozin to HF treatment is projected to provide economic benefits to the Japanese healthcare system.
达格列净对心力衰竭（HF）具有临床益处。然而，这些临床益处如何转化为经济负担的减轻尚不清楚。通过IMPLICATION HF研究，我们使用成本抵消模型预测了在日本使用达格列净可减少的HF事件和成本。
建模人群包括来自DAPA-HF和DELIVER试验的有症状HF患者。我们使用已发表文献中的日本HF患病率、事件发生率和事件成本，以及DAPA-HF和DELIVER汇总荟萃分析中的达格列净治疗效果，比较了使用和不使用达格列净治疗HF时的事件发生率及相关成本。预测了事件（HF住院[hHF]、心血管[CV]死亡和全因死亡）的累积数量及相关成本（hHF、CV死亡、总计）。根据使用和不使用达格列净治疗HF时事件相关成本的差异计算成本抵消。据估计，达格列净可预防63,770例hHF事件（治疗所需人数[NNT]为20）、11,613例CV死亡（NNT为108）和16,141例全因死亡（NNT为78），并在日本1年内使hHF和CV死亡成本分别降低627亿日元和166亿日元，总计793亿日元。敏感性分析证实了这些结果。
预计在HF治疗中添加达格列净将为日本医疗系统带来经济效益。
