BACKGROUND AND OBJECTIVE Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have significant efficacy in reducing the risk of hospitalization for heart failure (hHF) or cardiovascular (CV) mortality in patients with type 2 diabetes mellitus (T2DM). However, there are differences in HF outcomes between the SGLT2i. Therefore, we compared the cost needed to achieve these outcomes between empagliflozin, canagliflozin, and dapagliflozin. METHODS We calculated the cost needed to treat (CNT) in order to prevent one event of hHF or CV mortality, by multiplying the annualized number needed to treat (NNT) to prevent one event, by the annual cost of each therapy. Efficacy estimates were extracted from published randomized controlled trial (RCT) data. A sensitivity analysis was performed to mitigate differences between the RCT populations. Drug costs were extracted from the 2020 US National Average Drug Acquisition Cost listing. RESULTS We figured empagliflozin's CNT to be $664,464 (95% CI $499,872-$1,097,280), $1,535,387 (95% CI $886,074-$3,210,501) for canagliflozin, and $2,693,145 (95% CI $1,639,563-$11,092,206) for dapagliflozin. The sensitivity analysis confirmed the cost advantage of empagliflozin. CONCLUSIONS Our findings suggest that empagliflozin prescribed for preventing CV death or hHF in T2DM patients seems to be cost saving compared to treatment with canagliflozin, and dapagliflozin.

中文翻译：

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钠-葡萄糖共转运蛋白2抑制剂可预防2型糖尿病患者的心力衰竭事件：每项结果成本分析。

背景和目的钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）在降低2型糖尿病（T2DM）患者因心力衰竭（hHF）或心血管（CV）死亡率的住院风险方面具有显着功效。但是，SGLT2i之间的HF结果有所不同。因此，我们比较了依帕列净，canagliflozin和dapagliflozin达到这些结果所需的成本。方法我们通过将预防一种事件所需的治疗（NNT）的年化数量乘以每种疗法的年均成本，计算出预防一项hHF或CV死亡所需的治疗（CNT）成本。从公开的随机对照试验（RCT）数据中提取功效评估。进行敏感性分析以减轻RCT人群之间的差异。药品成本是从2020年美国国家平均药品采购成本清单中提取的。结果我们计算得出恩帕格列净的CNT为664,464美元（95％CI为499,872美元至1,097,280美元），1,535,387美元（95％CI为886,074美元至3,210,501美元），而canagliflozin则为2,693,145美元（95％CI为1,639,563美元-11,092,206美元）。敏感性分析证实了恩帕格列净的成本优势。结论我们的研究结果表明，与卡格列净和达格列净治疗相比，处方用于预防T2DM患者CV死亡或hHF的依帕格列净似乎节省了成本。敏感性分析证实了依帕列净的成本优势。结论我们的研究结果表明，与使用canagliflozin和dapagliflozin治疗相比，处方用于预防T2DM患者的CV死亡或hHF的依帕格列净似乎可以节省成本。敏感性分析证实了恩帕格列净的成本优势。结论我们的研究结果表明，与使用canagliflozin和dapagliflozin治疗相比，处方用于预防T2DM患者的CV死亡或hHF的依帕格列净似乎可以节省成本。