{"id":"7d7562a57093","type":"article","url":"https://hartvaat.nl/2026/10/01/dapagliflozin-kosteneffectief-bij-chronisch-hartfalen-economische-evaluatie-in-a/","title":"Dapagliflozin kosteneffectief bij chronisch hartfalen — economische evaluatie in Argentinië","title_en":"Economic evaluation of dapagliflozin added to standard therapy in chronic heart failure in Argentina: a cost-utility analysis.","category":"hartfalen","category_label":"Hartfalen","professions":["apotheker","cardioloog","internist"],"tags":[],"journal":"Lancet regional health. Americas","doi":"10.1016/j.lana.2026.101571","source_url":"https://doi.org/10.1016/j.lana.2026.101571","authors":["Javier Santiago Araujo","Francisco Moioni","Diego Sebastián Novielli","Germán Andrés Jelusic","Sofía Inés Lucini","Jeremías Augusto Zabalo","José Alberto Spala","María Celeste Piervincenzi"],"significance":5,"published":"2026-08-05","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/sglt2-remmers-bij-hartfalen/","https://hartvaat.nl/kennis/hartfalen/wat-is-hartfalen/"],"congress":"","summary_en":"A cost-utility analysis in Argentina demonstrates that adding dapagliflozin to standard therapy for chronic heart failure is cost-effective. Based on DAPA-HF and DELIVER trial data, dapagliflozin yielded an incremental gain of 0.76 and 0.44 QALYs, with ICERs of US$6,672 and US$10,371 per QALY, respectively. At a willingness-to-pay threshold of 1 GDP per capita, the probability of cost-effectiveness was 97% for HFrEF and 73% for HFpEF/mHFrEF. While region-specific, these findings reinforce the established value of SGLT2 inhibitors in heart failure and highlight the importance of pricing strategies and reimbursement policies for equitable patient access.","created":"2026-07-30T00:54:28Z","updated":"2026-08-10T10:37:01Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een kosten-utility-analyse in Argentinië toont aan dat dapagliflozin toegevoegd aan standaardtherapie bij chronisch hartfalen kosteneffectief is. Op basis van de DAPA-HF- en DELIVER-studies resulteerde toevoeging tot een incrementele winst van 0,76 respectievelijk 0,44 QALY, met ICER van US$ 6.672 en US$ 10.371 per QALY. Bij een drempel van 1 bbp per hoofd van de bevolking is de kans op kosteneffectiviteit 97% voor HFrEF en 73% voor HFpEF/mHFrEF. Voor de klinische praktijk bevestigt dit de onderbouwing van SGLT2-remmers bij hartfalen, waarbij prijsafspraken en zorgverzekeringbeslissingen de toegankelijkheid voor patiënten bepalen.","abstract_original":"BACKGROUND: Heart failure is associated with high morbidity, mortality, and substantial resource use. Dapagliflozin improves outcomes in heart failure, but local economic evidence for Argentina is limited. We conducted a cost-utility analysis of dapagliflozin added to standard therapy for chronic heart failure in Argentina. METHODS: We conducted a cost-utility analysis from the Argentine public health system perspective using two trial-based Markov models (DAPA-HF and DELIVER populations), monthly cycles, lifetime horizon, and 3% annual discounting for costs and outcomes. Inputs were derived from published trial data and Argentine sources where available. We estimated costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs), and performed deterministic and probabilistic sensitivity analyses. FINDINGS: In the DAPA-HF model, dapagliflozin increased QALYs by 0.76 with an incremental cost of US$5069, yielding an ICER of US$6672 per QALY. In the DELIVER model, dapagliflozin increased QALYs by 0.44 with an incremental cost of US$4542, yielding an ICER of US$10,371 per QALY. At a willingness-to-pay threshold of 1 gross domestic product (GDP) per capita, the probability of cost-effectiveness was 97% (DAPA-HF) and 73% (DELIVER). INTERPRETATION: Dapagliflozin added to standard therapy is likely to be cost-effective in Argentina, with greater robustness in heart failure with reduced ejection fraction. In preserved or mildly reduced ejection fraction, cost-effectiveness is compatible with a 1 GDP per capita threshold but more sensitive to key assumptions; price negotiation could improve value for money. FUNDING: None."}