Pharmacoeconomic analysis of the use of dapagliflozin in patients with NYHA class II–IV chronic heart failure with reduced left ventricular ejection fraction ≤40% in the Russian Federation

Aim. To evaluate the economic efficiency of using dapagliflozin in patients with chronic heart failure with a reduced left ventricular ejection fraction ≤40% NYHA II–IV in the Russian Federation Methods. Conducted a cost-benefit analysis/cost-minimization analysis and budget impact analysis. The calculation of costs was carried out in a global model adapted to the health care system of the Russian Federation by using Russian cost indicators and indicators of disease characteristics. Results. The addition of dapagliflozin to standard care compared to standard care only will provide an additional 0.356 LYGs (life years gained) and 0.306 QALYs (quality adjusted life years) for each patient during 10 years of therapy, which will lead to an additional cost of 33.32%. The incremental cost of 1 added year of life with dapagliflozin will amount to 460 943 rubles per patient, 1 year of life adjusted for quality – 537 230 rubles, which does not exceed the value of one GDP per capita in 2019 (749 813 rubles). Thus intensification of CHF therapy with dapagliflozin is economically viable. At the same time, the use of dapa-gliflozin for 10 years in 1000 target patients will avoid 128 hospitalizations and 23 urgent outpatient visits for CHF, as well as prevent 47 CV deaths. The NNT (number need to treat) index for the compared strategies for hospitalization for CHF is only 8 people. Intensification of standard therapy for CHF with dapagliflozin in comparison with valsartan/sacubitril will reduce the costs of the healthcare system by 29 417 rubles per patient for one year of therapy and 73 167 rubles per patient over 3 years of therapy with comparable efficiency.