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Background <p>This study was aimed at analysing the association between socioeconomic factors and SGLT2 inhibitor (SGLT2i) initiation in patients with heart failure.</p> Methods <p>In this retrospective analysis, German health insurance claims data from 2022 to 2023 were used, covering more than 2.8 million individuals. Heart failure was defined using ICD–10–GM codes. Area-based socioeconomic data were obtained from the INKAR database. Associations were assessed using a multilevel logistic regression analysis.</p> Results <p>In 2023, 90,841 individuals were diagnosed with heart failure. After excluding patients with prior SGLT2i use in 2022 and those with missing data, 68,426 SGLT2i-naive individuals were included in the analysis. A higher likelihood of SGLT2i initiation was associated with newly coded heart failure (adjusted odds ratio (aOR): 2.42, 95% CI 2.29–2.56) and new enrolment in a disease management program for coronary artery disease (aOR: 1.89, 95% CI 1.68–2.12). Being a pensioner (aOR: 0.86, 95% CI 0.78–0.93), having family insurance (aOR: 0.79, 95% CI 0.66–0.95), moving (aOR: 0.80, 95% CI 0.67–0.95), being female (aOR: 0.83, 95% CI 0.78–0.87), and older age (aOR: 0.37, 95% CI 0.18–0.76) were negatively associated. At the municipal level, residing in a higher-income tax municipality (aOR: 1.70, 95% CI 1.37–2.09) was positively related to SGLT2i initiation. These associations were adjusted for other socioeconomic factors, comorbidities, and heart failure medications.</p> Conclusions <p>Women and individuals living in socioeconomically disadvantaged municipalities were less likely to receive SGLT2i initiation for heart failure.</p> Graphical Abstract <p></p>

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Socioeconomic factors and SGLT2 inhibitor initiation in patients with heart failure—a claims data analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月7日

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  • Lisa–Marie Müller,
  • Jonas Krampe,
  • Julius L. Katzmann,
  • Ulrich Laufs,
  • Alexander Kogel

摘要

Background

This study was aimed at analysing the association between socioeconomic factors and SGLT2 inhibitor (SGLT2i) initiation in patients with heart failure.

Methods

In this retrospective analysis, German health insurance claims data from 2022 to 2023 were used, covering more than 2.8 million individuals. Heart failure was defined using ICD–10–GM codes. Area-based socioeconomic data were obtained from the INKAR database. Associations were assessed using a multilevel logistic regression analysis.

Results

In 2023, 90,841 individuals were diagnosed with heart failure. After excluding patients with prior SGLT2i use in 2022 and those with missing data, 68,426 SGLT2i-naive individuals were included in the analysis. A higher likelihood of SGLT2i initiation was associated with newly coded heart failure (adjusted odds ratio (aOR): 2.42, 95% CI 2.29–2.56) and new enrolment in a disease management program for coronary artery disease (aOR: 1.89, 95% CI 1.68–2.12). Being a pensioner (aOR: 0.86, 95% CI 0.78–0.93), having family insurance (aOR: 0.79, 95% CI 0.66–0.95), moving (aOR: 0.80, 95% CI 0.67–0.95), being female (aOR: 0.83, 95% CI 0.78–0.87), and older age (aOR: 0.37, 95% CI 0.18–0.76) were negatively associated. At the municipal level, residing in a higher-income tax municipality (aOR: 1.70, 95% CI 1.37–2.09) was positively related to SGLT2i initiation. These associations were adjusted for other socioeconomic factors, comorbidities, and heart failure medications.

Conclusions

Women and individuals living in socioeconomically disadvantaged municipalities were less likely to receive SGLT2i initiation for heart failure.

Graphical Abstract