The landscape of clinical trials for heart failure with preserved ejection fraction (HFpEF) is littered with failed therapies, in stark contrast with that for heart failure with reduced ejection fraction (HFrEF) in which multiple therapies have been shown to improve survival and quality of life. Among therapies tested for HFpEF, the sodium-glucose cotransporter-2 (SGLT2) inhibitors empagliflozin and dapagliflozin are the first 2 drugs to demonstrate benefit in large-scale outcomes trials by reducing the composite of cardiovascular death, heart failure hospitalization, and in the DELIVER trial, urgent heart failure visits.1,2 While these therapies have been appropriately seen as a breakthrough by the cardiology community, they come with a hefty price tag of more than $4000 annually. With over 3 million individuals affected by HFpEF, the potential impact on health care spending is substantial.3 Therefore, it is critical to understand the economic value of SGLT2 inhibitors for HFpEF by carefully comparing the costs with the expected clinical benefit.