A patient-level Markov microsimulation applied SOLOIST-WHF treatment effects, US cost estimates and externally derived utilities to project lifetime outcomes for patients with type 2 diabetes starting sotagliflozin around discharge for worsening heart failure. Over a lifetime horizon the model gave 0.39 additional QALYs and 0.64 additional life-years at an incremental cost of $29,449, an ICER of $75,510 per QALY. The ratio was $71,135 per QALY in preserved ejection fraction and $87,635 in reduced ejection fraction, with results most sensitive to medication cost and readmission rates.
Why it is interesting: The ratio is lower in preserved than in reduced ejection fraction and is most sensitive to medication cost and readmission rates.