Sotagliflozin Cost-Effective for Heart Failure and Diabetes Patients, finds JACC Study

A recent analysis of the SOLOIST-WHF trial published in the JACC: Heart Failure provided strong evidence on the cost-effectiveness of sotagliflozin for patients with diabetes and recent worsening of heart failure. While the SOLOIST-WHF trial had already demonstrated the efficacy of sotagliflozin in improving health outcomes for these patients, the economic impact of the drug had not been thoroughly investigated.

The study was set out to evaluate whether sotagliflozin is a cost-effective treatment option for patients with diabetes and recent worsening of heart failure. This evaluation is crucial for informing healthcare policy and ensuring that the benefits of the drug justify its costs within the U.S. healthcare system.

To determine the cost-effectiveness of sotagliflozin, the research team developed a Markov model based on data from the SOLOIST-WHF trial, which included a total of 1,222 patients. The model estimated the lifetime impact of sotagliflozin from the perspective of the U.S. healthcare sector. Cost data were drawn from the National Inpatient Sample, while the life expectancy projections were based on census data, adjusted by the mortality rates observed in the SOLOIST-WHF trial. Event rates for both fatal and nonfatal incidents were extrapolated from trial data and utility values were derived from published reports.

The analysis revealed that patients treated with sotagliflozin had a lifetime quality-adjusted life-year (QALY) of 4.43 when compared to 4.04 for the patients who were receiving a placebo. However, this improvement in quality of life came at a higher cost: lifetime costs were $220,113 for the sotagliflozin group against $188,198 for the placebo group.

Despite the increased costs, the incremental cost-effectiveness ratio (ICER) was calculated at $81,823 per QALY gained. This metric is vital for determining the value of medical interventions as it compares the additional cost of a treatment to the additional health benefits it provides.

The study assessed the probability of sotagliflozin being cost-effective at various willingness-to-pay thresholds. At a threshold of $50,000 per QALY gained, the probability was 3.6%. This probability increased significantly to 67.5% at a threshold of $100,000 per QALY gained and further to 89.4% at $150,000 per QALY gained.

The findings indicated that sotagliflozin is a cost-effective treatment for patients with diabetes and recent worsening of heart failure when evaluated against commonly accepted willingness-to-pay thresholds in the U.S. healthcare system. Overall, this cost-effectiveness supports the inclusion of sotagliflozin in treatment protocols for these patients by potentially leading to better health outcomes and optimized resource allocation in healthcare settings.

Source:

Weintraub, W. S., Kolm, P., Dolman, S., Alva, M., Bhatt, D. L., & Zhang, Z. (2024). Cost-Effectiveness of Sotagliflozin in SOLOIST-WHF. In JACC: Heart Failure. Elsevier BV. https://doi.org/10.1016/j.jchf.2024.04.018