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4.2.8. SGLT2 Inhibitors and GLP-1 Receptor Agonists
COR LOE
Recommendations
1 A 1. In patients with CCD who have type 2 diabetes,
the use of either an SGLT2 inhibitor or a GLP-1
receptor agonist with proven cardiovascular benefit is
recommended to reduce the risk of MACE.
Cost Value
Statement:
High Value
B-NR 2. In patients with CCD and type 2 diabetes, addition of a
GLP-1 receptor agonist at US prices is projected to be of
high value compared with standard of care.
Cost Value
Statement:
Intermediate
Value
B-NR 3. In patients with CCD and type 2 diabetes, addition of
an SGLT2 inhibitor at US prices is projected to be of
intermediate value compared with standard of care.
1 A 4. In patients with CCD and heart failure with LVEF
≤40%, use of an SGLT2 inhibitor is recommended to
reduce the risk of cardiovascular death and heart failure
hospitalization and to improve QOL, irrespective of
diabetes status.*
Cost Value
Statement:
Intermediate
Value
B-NR 5. In patients with CCD and heart failure with LVEF
≤40%, addition of an SGLT2 inhibitor to GDMT,
irrespective of diabetes status, is projected to be of
intermediate value at US prices.
2a B-R 6. In patients with CCD and heart failure with LVEF
>40%, use of an SGLT2 inhibitor can be beneficial in
decreasing heart failure hospitalizations and to improve
QOL, irrespective of diabetes status.
Cost Value
Statement:
Intermediate
Value
B-NR 7. In patients with CCD and heart failure with LVEF
>40%, addition of an SGLT2 inhibitor to GDMT,
irrespective of diabetes status, is projected to be of
uncertain value at US prices.
* Modified from the 2022 AHA/ACC/HFSA guideline for the management of heart failure.
Heidenreich PA, et al. J Am Coll Cardiol. 2022;79:e263-e421.
