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Adding sodium-glucose cotransporter 2 (SGLT2) inhibitors to standard medical therapy for heart failure with preserved ejection fraction (HFpEF) provides just ...

[Cost-effectiveness of sodium-glucose cotransporter-2 inhibitors for patients with heart failure and preserved ejection fraction – living on the edge](https://jamanetwork.com/journals/jamacardiology/fullarticle/2802216). [Cost-effectiveness of sodium-glucose cotransporter-2 inhibitors for the treatment of heart failure with preserved ejection fraction](https://jamanetwork.com/journals/jamacardiology/fullarticle/2802215). He pointed to parts of the Inflation Reduction Act, which was signed into law last year, that are aimed at controlling drug costs through negotiation of the prices of top-selling medications, limiting price increases so they cannot exceed rises in inflation, and capping out-of-pocket costs at $2,000 per year. But I think it is really a matter of shared decision-making, helping patients understand the expected benefit and their out-of-pocket costs to make the decision whether the treatment is valuable to them.” So how the therapy effectiveness seen in these trials would translate to clinical benefit and cost-effectiveness in a general practice population remains an important question.” In particular, real-world patients tend to be sicker, with higher rates of chronic kidney disease (CKD), worse health status, and greater risks of hospitalization and death. Francis Hospital and Heart Center, Roslyn, NY), said the findings of this analysis are generally consistent with a What’s more surprising, she added, is that even with the lesser impact on CV mortality and the high cost of the drugs, they remained in the “intermediate-value” range. The analyses assumed a 12% relative reduction in CV death (HR 0.88), and when the HR went higher—ie, less beneficial effect—the addition of SGLT2 inhibitors became a low-value approach. That bump in QALYs came at the cost of $26,312 in direct health spending compared with standard care, resulting in an incremental cost-effectiveness ratio (ICER) of $141,200 per QALY gained. In the US Medicare population alone, there are roughly 3 million people with HFpEF, and that number is on the rise, Kazi noted. On the other hand, lowering the cost of using the drugs—currently $4,000 a year or more—would shift them into the high-value category, researchers led by Laura Cohen, MD (Massachusetts General Hospital, Boston, MA), report in a study published online recently in JAMA Cardiology.