Background: The updated National Institute for Health and Care Excellence (NICE) type 2 diabetes (T2D) guidelines extend the recommendation of SGLT2 inhibitors (SGLT2i) for hyperglycaemia management to include their use in those with atherosclerotic cardiovascular disease (ASCVD), chronic heart failure (HF), chronic kidney disease (CKD) or high CVD risk. Our study estimates the potential cost consequence in the UK of the broad positioning of SGLT2i within updated guidelines (NG28-2022) versus previous guidelines (NG28-2015). Methods: The Cardiff T2D model was used to project lifetime outcomes and costs for T2D patients across established UK treatment pathways including metformin, sulfonylurea, DPP-4 inhibitors and NPH insulin with or without SGLT2i combination to reflect former vs. updated guidelines. Analyses were conducted in four subgroups (ASCVD, HF with reduced ejection fraction (HFrEF), CKD, high CVD risk). Projected outcomes were extrapolated to national level using population estimates from NICE’s guideline companion resource impact report. Results: Predicted lifetime costs for 1.7 Mn SGLT2i eligible T2D patients in the UK were estimated at £87.1 Bn with NG28-2022 compared to £101.7 Bn with NG28-2015. Net savings associated with NG28-2022 management of £14.56 Bn were attributable to comorbid CKD (£5.09 Bn), high CVD risk (£4.77 Bn), ASCVD (£3.96 Bn) and comorbid HFrEF (£0.74 Bn). Overall net savings were predicted despite an increase in pharmacy costs of £5.57 Bn. Changes in metabolic parameters and reduction in cardiovascular and kidney progression rates were predicted to prevent 20183 myocardial infarction events, 66651 HF events and 140303 events of end stage kidney failure. The magnitude of savings was a combination of event reductions and the number of eligible patients in subgroups. Conclusion: Our study indicates that uptake of SGLT2 inhibitors in line with NICE guidelines has the potential to improve health and be cost saving despite an increase in pharmacy costs. Disclosure P.Mcewan: Other Relationship; AstraZeneca. V.Foos: Other Relationship; AstraZeneca. R.Martin: Employee; AstraZeneca. J.Chen: Employee; AstraZeneca, Eli Lilly and Company.
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.