Background: The efficacy and safety of sotagliflozin, a novel therapy for the treatment of patients with heart failure, was demonstrated in SOLOIST-WHF, but its economic value is yet to be determined. This study assesses the cost-effectiveness of sotagliflozin for the treatment of patients hospitalized with heart failure and comorbid diabetes. Methods: An economic model with a Markov structure was created for patients hospitalized for heart failure with comorbid diabetes. Outcomes of interest included hospital readmissions, emergency department visits, and all-cause mortality measured over a 30-year time horizon. Baseline event frequencies were derived from published real-world data studies; sotagliflozin's efficacy was estimated from SOLOIST-WHF. Health benefits were synthesized using quality-adjusted life years. Costs included pharmaceutical costs, rehospitalization, emergency room visits and adverse events. Economic value was measured using the incremental cost effectiveness ratio. Results: Sotagliflozin use decreased annualized rehospitalization rates by 34.5% (0.228 vs. 0.348, difference: -0.120), annualized emergency department visits by 40.0% (0.091 vs. 0.153, difference: -0.061), and annualized mortality by 18.0% (0.298 vs. 0.363, difference: -0.065) relative to standard of care, resulting in a net gain in quality adjusted life-years of 0.425 for sotagliflozin vs. standard of care. Incremental costs using sotagliflozin increased by $19,374 over the lifetime of the patient, driven largely by increased pharmaceutical cost. Estimated incremental cost effectiveness ratio was $45,596 per quality adjusted life-year. Conclusions: Sotagliflozin is a cost-effective addition to standard of care for patients hospitalized with heart failure and comorbid diabetes.

J. Shafrin, J. Kim and S. Wang are employees of FTI Consulting, a publicly traded company that provides services to various public and private entities in the health care, life sciences and other industries. S. Sikirica is an employee of and holds equity in Lexicon Pharmaceuticals.

Funding for this research was provided by Lexicon Pharmaceuticals.

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