Highlights
- •Half of patients with HF have reduced ejection fraction (HFrEF), but few claims data studies tried to analyze them.
- •Patients with HF eligible to SGLT2-Is(HFrEF) are analyzed through Italian primary care and administrative databases
- •From this study, 20% patients with HF are eligible to SGLT2-Ibased on DAPA-HF trial’s criteria.
- •High comorbidity rates (>90%), frequent cause of HF hospitalization(e.g. diabetes), are consistent between the databases.
- •A slightly higher mean annual cost per patient with HF eligible to SGLT2-Is (vs general HF population) is found.
Abstract
Background
Recent successful findings (i.e. DAPA-HF trial) in patients with heart failure (HF)
with/without diabetes treated with sodium-glucose co-transporter inhibitors (SGLT2-I)
have fostered real-world data analyses. Fondazione Ricerca e Salute's (ReSD) administrative
and Health Search's (HSD) primary healthcare databases were combined in the ReS-HS
DB Consortium, to identify and characterize HF-patients eligible to SGLT2-I, and assess
their costs charged to the Italian National Health Service (INHS).
Methods and results
Eligibility to SGLT2-I was HF diagnosis, age ≥ 18 years, reduced (≤40%) ejection fraction
(HFrEF) and glomerular filtration rate (GFR) ≥30 ml/min. The HSD, including 13,313
HF-patients (1.5% of the total HSD population) was used to develop and test the algorithms
for imputing HFrEF and GFR ≥ 30 ml/min, based on a set of covariates, to the ReSD,
including 67,369 (1.5% of the total ReSD population). Subjects eligible to SGLT2-I
were 2187 in HSD (61.1% of HFrEF); after the imputation, 15,145 in ReSD (58.8% of
HFrEF). Prevalence of eligibility to SGLT2-I was higher in males then in females and
increased with age; diabetic patients were 44.3% and 33.4% of HSD and ReSD populations
eligible to SGLT2-I, respectively. Estimated from ReSD, the mean annual cost charged
to the INHS per patient with HF eligible to SGLT2-I was €7122 (68% due to hospitalizations).
Conclusions
Approximately 20% of patients with HF was eligible to SGLT2-I. Real-world data can
identify, quantify and characterize patients eligible to SGLT2-Is and assess related
costs for the health care system, thus providing useful information to Regulatory
Decision makers.
Keywords
Abbreviations:
ATC (Anatomical Therapeutic Chemical), CV (Cardiovascular), EF (Ejection Fraction), GFR (Glomerular Filtration Rate), GP (General Practitioner), HSD (Health Search's primary care database), HF (Heart Failure), HFrEF (Heart Failure with Reduced Ejection Fraction), ICD-9-CM (International Classification of Diseases - 9th Revision - Clinical Modification), INHS (Italian National Health Service), LHA (Local Healthcare Authority), ReSD (Fondazione Ricerca e Salute's database), RHA (Regional Healthcare Authority), SGLT2-I (Sodium-Glucose Transporter 2 Inhibitor)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: September 26, 2022
Accepted:
September 21,
2022
Received in revised form:
September 8,
2022
Received:
July 22,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
