TCT-494 Cost-Effectiveness of SGLT2 Inhibitors, Statins, and GLP-1 Receptor Agonists for Cardiovascular Secondary Prevention: A Comparative Analysis

Document Type

Abstract

Publication Date

10-28-2025

Abstract

Background: Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. Several pharmacologic therapies including sodium-glucose co-transporter 2 (SGLT2) inhibitors, statins, and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated cardiovascular benefit in high-risk populations. This study evaluates and compares the cost-effectiveness of these agents in secondary prevention of cardiovascular events. Methods: A systematic review and comparative cost-effectiveness analysis were performed based on studies published between 2015 and 2025. We included randomized controlled trials and model-based economic evaluations reporting incremental cost-effectiveness ratios (ICERs) in patients with established cardiovascular disease. Outcomes included cost per quality-adjusted life year (QALY) gained, major adverse cardiovascular events (MACE) reduction, and treatment-specific adverse events. Results: Statins demonstrated the highest cost-effectiveness, with ICERs ranging from $2,500 to $10,000 per QALY gained. SGLT2 inhibitors had moderate ICERs between $15,000 and $50,000 per QALY, particularly cost-effective in patients with heart failure or chronic kidney disease. GLP-1 RAs had higher ICERs, ranging from $60,000 to $120,000 per QALY gained, primarily due to higher drug costs. All three drug classes showed significant MACE reduction compared to placebo, with the greatest relative risk reduction seen in statins (RR 0.78), followed by SGLT2i (RR 0.85) and GLP-1 RAs (RR 0.88). Conclusion: Statins remain the most cost-effective agent for cardiovascular secondary prevention. SGLT2 inhibitors offer favorable cost-effectiveness in specific subgroups, particularly patients with heart failure or diabetes. GLP-1 RAs, while effective, may require price reductions to achieve cost-effectiveness thresholds in most health systems. Categories: CORONARY: Pharmacology/Pharmacotherapy

Publication Title

Journal of the American College of Cardiology

Volume

86

Issue

17 Supplement

First Page

B216

Last Page

B217

Comments

Transcatheter Cardiovascular Therapeutics held 2025-10-25 to 2025-10-28 in San Francisco, CA

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