Medical Journal of The Islamic Republic of Iran (MJIRI)
Iran University of Medical Sciences
Fri, Jan 30, 2026
[Archive]
Volume 39, Issue 1 (1-2025)
Med J Islam Repub Iran 2025 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Rezaeian M, Nasirzadeh M, Tashakori-Miyanroudi M, Rezapour A, Hghjoo M, Souresrafil A. Economic Evaluation of Sodium-Glucose Cotransporter-2 Inhibitors in Patients with Heart Failure with Preserved or Mildly Reduced Ejection Fraction: A Systematic Review. Med J Islam Repub Iran 2025; 39 (1) :1446-1459
URL: http://mjiri.iums.ac.ir/article-1-9771-en.html
URL: http://mjiri.iums.ac.ir/article-1-9771-en.html
Mohsen Rezaeian 
, Mostafa Nasirzadeh , Mahsa Tashakori-Miyanroudi , Aziz Rezapour , Majid Hghjoo , Aghdas Souresrafil
, Mostafa Nasirzadeh , Mahsa Tashakori-Miyanroudi , Aziz Rezapour , Majid Hghjoo , Aghdas Souresrafil
Department of Health Services and Health Promotion, School of Health, Occupational Environment Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran , asouresrafil@gmail.com
Abstract: (13 Views)
Background: Heart Failure (HF) is a complex and life-threatening syndrome with substantial morbidity, mortality, diminished function, and high healthcare costs. Several studies have demonstrated that sodium-glucose co-transporter 2 inhibitors (SGLT2i) are very promising for improving HF outcomes in patients with preserved ejection fraction (HFpEF) or mild reduction in ejection fraction (HFmrEF). A review of the cost-effectiveness of SGLT2 inhibitors for the treatment of HFpEF is essential to help clinicians and decision-makers identify the most cost-effective treatment option for HF. The purpose of this study was to review economic studies on the addition of SGLT-2i to HFpEF or HFmrEF.
Methods: In this systematic review, searches were conducted across PubMed, Scopus, Web of Science, and EMBASE databases from January 2020 to March 2025. Full economic evaluations of adding SGLT-2i in HF with HFpEF or HFmrEF were included for data extraction. Articles were screened at the title, abstract, and full-text levels. The data were extracted into an Excel table, and the narrative synthesis was performed. The quality of the studies was assessed using the CHEERS 2022 criteria.
Results: A total of 421 references were screened after removing duplicates. Twenty-one studies were identified that examined full economic evaluations of adding SGLT-2i in HFpEF or HFmrEF. Most studies were from China and the USA. The highest and lowest incremental costs per quality-adjusted life year for empagliflozin were in China ($10961.971) and the United States ($48,527.33) (healthcare system perspective). In most countries except Thailand, empagliflozin or dapagliflozin plus standard care (SoC) is more cost-effective than SoC alone in patients with HFpEF or HFmrEF.
Conclusion: Study results indicate that adding SGLT2i to SoC is cost-effective in patients with HFpEF or HFmrEF. Moreover, further studies comparing dapagliflozin and empagliflozin in this patient group are needed.
Methods: In this systematic review, searches were conducted across PubMed, Scopus, Web of Science, and EMBASE databases from January 2020 to March 2025. Full economic evaluations of adding SGLT-2i in HF with HFpEF or HFmrEF were included for data extraction. Articles were screened at the title, abstract, and full-text levels. The data were extracted into an Excel table, and the narrative synthesis was performed. The quality of the studies was assessed using the CHEERS 2022 criteria.
Results: A total of 421 references were screened after removing duplicates. Twenty-one studies were identified that examined full economic evaluations of adding SGLT-2i in HFpEF or HFmrEF. Most studies were from China and the USA. The highest and lowest incremental costs per quality-adjusted life year for empagliflozin were in China ($10961.971) and the United States ($48,527.33) (healthcare system perspective). In most countries except Thailand, empagliflozin or dapagliflozin plus standard care (SoC) is more cost-effective than SoC alone in patients with HFpEF or HFmrEF.
Conclusion: Study results indicate that adding SGLT2i to SoC is cost-effective in patients with HFpEF or HFmrEF. Moreover, further studies comparing dapagliflozin and empagliflozin in this patient group are needed.
Type of Study: Systematic Review |
Subject:
Health Management and Economics
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
