Cost-effectiveness of dapagliflozin for the treatment of heart failure: a systematic review
Bibliographic record
Abstract
Objective: This study aims to synthesize evidence on the cost-effectiveness of dapagliflozin for heart failure (HF) with all ejection fractions (EF), Including heart failure with reduced ejection fraction (HFrEF), heart failure with mildly reduced ejection fraction (HFmrEF) and heart failure with preserved ejection fraction (HFpEF). Methods: Literature searches were conducted in English-language databases (PubMed, web of science, Embase, Cochrane Library) and Chinese-language databases (CNKI, Wanfang Data, and Chongqing VIP) to identify studies of dapagliflozin for heart failure. The search was current to 3 October 2024. Results: Twenty-eight studies were identified in the systematic review and the overall quality was accepted. Studies were conducted across 15 countries including China, UK, US, Japan, South Korea, Singapore, Thailand, Australia, Egypt, Colombia, Philippines, Qatar, Canadian, German, and Spanish. Cost-effectiveness analyses of dapagliflozin were performed for HFrEF patients in all countries, HFpEF patients in the US and China, HFpEF/HFmrEF patients in the UK, Germany, Spain and China and HF patients in the UK, US, Korea and Thailand. Except for one study in Thailand, all studies showed that dapagliflozin is cost-effective. One study in Korea showed that the cost-effectiveness of dapagliflozin in patients with left ventricular EF (LVEF)≤40% was more pronounced than LVEF >40%. Four studies (two HFrEF and one HFpEF in the US and one HFrEF in China) showed that dapagliflozin was more cost-effective than empagliflozin. In the nine diabetes subgroup analyses, seven results showed that dapagliflozin was more cost-effective for patients with diabetes. The incremental cost-effectiveness ratios (ICER)were most sensitive to the cost of dapagliflozin and cardiovascular mortality in the uncertainty analysis. Conclusion: Dapagliflozin is cost-effective in the treatment of HF with all ejection fractions. The cost-effectiveness of patients with LVEF≤40% (HErEF)was more pronounced than LVEF >40% (HFpEF and HFmrEF). Compared to empagliflozin, dapagliflozin may be more cost-effective.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.045 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.010 | 0.011 |
| Bibliometrics | 0.010 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".