How many and who are patients with heart failure eligible to SGLT2 inhibitors? Responses from the combination of administrative healthcare and primary care databases.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
15 Jan 2023
Historique:
received: 22 07 2022
revised: 08 09 2022
accepted: 21 09 2022
pubmed: 30 9 2022
medline: 15 12 2022
entrez: 29 9 2022
Statut: ppublish

Résumé

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). 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). 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.

Sections du résumé

BACKGROUND 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 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 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.

Identifiants

pubmed: 36174826
pii: S0167-5273(22)01403-6
doi: 10.1016/j.ijcard.2022.09.053
pii:
doi:

Substances chimiques

Sodium-Glucose Transporter 2 Inhibitors 0
Glucosides 0
Benzhydryl Compounds 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

236-243

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The financial support for this study was provided with a funding agreement ensuring maintenance of author independence in study design, data interpretation, writing, and decisions to publish. APM received personal fees for the participation in clinical studies supported by Bayer, Novartis Italia, Fresenius and AstraZeneca Italia, outside the present work. The other authors declare no conflict of interest.

Auteurs

Carlo Piccinni (C)

Fondazione ReS (Ricerca e Salute - Health and Research Foundation), Rome, Italy.

Letizia Dondi (L)

Fondazione ReS (Ricerca e Salute - Health and Research Foundation), Rome, Italy.

Silvia Calabria (S)

Fondazione ReS (Ricerca e Salute - Health and Research Foundation), Rome, Italy. Electronic address: calabria@fondazioneres.it.

Giulia Ronconi (G)

Fondazione ReS (Ricerca e Salute - Health and Research Foundation), Rome, Italy.

Antonella Pedrini (A)

Fondazione ReS (Ricerca e Salute - Health and Research Foundation), Rome, Italy.

Francesco Lapi (F)

Health Search - Istituto di Ricerca della S.I.M.G, Firenze, Italy.

Ettore Marconi (E)

Health Search - Istituto di Ricerca della S.I.M.G, Firenze, Italy.

Damiano Parretti (D)

Health Search - Istituto di Ricerca della S.I.M.G, Firenze, Italy.

Gerardo Medea (G)

Health Search - Istituto di Ricerca della S.I.M.G, Firenze, Italy.

Claudio Cricelli (C)

Health Search - Istituto di Ricerca della S.I.M.G, Firenze, Italy.

Nello Martini (N)

Fondazione ReS (Ricerca e Salute - Health and Research Foundation), Rome, Italy.

Aldo Pietro Maggioni (AP)

Fondazione ReS (Ricerca e Salute - Health and Research Foundation), Rome, Italy; ANMCO Research Center Heart Care Foundation, Firenze, Italy.

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Classifications MeSH