# Dapagliflozin kosteneffectief bij chronisch hartfalen — economische evaluatie in Argentinië

*geplaatst 2026-08-05 · Hartfalen · Lancet regional health. Americas · doi 10.1016/j.lana.2026.101571 · https://hartvaat.nl/2026/10/01/dapagliflozin-kosteneffectief-bij-chronisch-hartfalen-economische-evaluatie-in-a/*

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.

## English: Economic evaluation of dapagliflozin added to standard therapy in chronic heart failure in Argentina: a cost-utility analysis.

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.

## Abstract (original, from the publication)

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.

Auteurs: Javier Santiago Araujo, Francisco Moioni, Diego Sebastián Novielli, Germán Andrés Jelusic, Sofía Inés Lucini, Jeremías Augusto Zabalo, José Alberto Spala, María Celeste Piervincenzi

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Bron: Lancet regional health. Americas, https://doi.org/10.1016/j.lana.2026.101571. Bijgewerkt 2026-08-10T10:37:01Z. 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.