How many and who are patients with heart failure eligible to SGLT2 inhibitors? Responses from the combination of administrative healthcare and primary care databases. (15th January 2023)

• Record Type: Journal Article
• Authors: Piccinni, Carlo; Dondi, Letizia; Calabria, Silvia; Ronconi, Giulia; Pedrini, Antonella; Lapi, Francesco; Marconi, Ettore; Parretti, Damiano; Medea, Gerardo; Cricelli, Claudio; Martini, Nello; Maggioni, Aldo Pietro
• Is Part Of: International journal of cardiology. Volume 371(2023)
• Page Start: 236
• Page End: 243
• Publication Date: 2023-01-15
• Subjects: Heart failure -- Sodium-glucose transporter 2 inhibitors -- Ejection fraction -- Diabetes mellitus -- Primary health care -- Health care costs; 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; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2022.09.053
• Languages: English
• ISSNs: 0167-5273

Abstract

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. 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.