MATERIALS AND METHODS: A descriptive analysis was carried out using Laurie Brady's four-stage strategy. First, available curriculum materials were collected from four different institutions' electronic webpage: AIMST (Malaysia), GU (Australia), UO (New Zealand) and CMU (United Kingdom), and then compared based on three key domains: curriculum contents, teaching and learning strategies and assessments. Following that, the similarities and differences between various curricula were identified. Future recommendations and a curriculum framework were then proposed.

RESULTS: The core BDT curriculum content is concurred upon by all four universities, with an emphasis on basic sciences, laboratory materials, practical sessions and research projects. However, the credit weightage for each course or module varied across the four institutions, with some offering unique subjects and implementing different teaching methods and assessments. A simple BDT curriculum framework with a proposed syllabus was designed based on the three key domains and future recommendations for curriculum improvement were explored.

METHODS: A Microsoft Excel-based cost calculator was developed for such comparison. The estimated size of eligible population, uptake rates for dapagliflozin, as well as costs related to drugs, clinical events, and adverse events were based on published data, official tariffs, and databases, and expert opinion. Clinical data from the DAPA-HF trial were used to inform efficacy and safety inputs (i.e., hospitalization for heart failure (hHF), cardiovascular death, and adverse events). Results were reported as total annual and cumulative costs (in 2023 Malaysian Ringgits [RM], United States Dollars [USD], and European Union Euros, [EUR]; with exchange rates of 1 USD = RM 4.40 and 1 EUR = RM 4.90]), as well as the number of clinical events. Sensitivity and scenario analyses were also conducted.

FINDINGS: The base-case analysis estimated that over a five-year period, the adoption of dapagliflozin for HFrEF treatment would result in a cumulative cost-saving of RM 2.6 million (USD 0.6 million/EUR 0.5 million), representing a 0.3% reduction in costs, driven primarily by reduced expenditure on hHF. Moreover, dapagliflozin treatment would lead to 731 fewer hHF and 366 fewer cardiovascular deaths. Sensitivity and scenario analyses revealed that the results were most sensitive to assumptions regarding loop diuretic requirements and the cost of dapagliflozin. Although cost savings or a net-zero balance were projected for the first four years, an anticipated 2.5% annual increase in dapagliflozin uptake in the longer term would lead to additional costs for the MOH, starting from the fifth year.