Dapagliflozin seen as cost-effective for CKD in the United Kingdom, Germany, Spain
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In the United Kingdom, Germany and Spain, dapagliflozin with standard therapy is a cost-effective treatment for chronic kidney disease, according to data published in the Clinical Journal of the American Society of Nephrology.
“Our results indicate that should patients with CKD be treated with dapagliflozin at an early stage of disease, the rate of cardio-renal complications could be reduced leading to improved health-related quality of life in patients and significant benefits for health care systems in a cost-effective manner,” Phil McEwan, PhD, from Health Economics and Outcomes Research Ltd. in Cardiff, Wales, and colleagues wrote.
Following the results of the Dapagliflozin and Prevention of Adverse Outcomes in CKD (DAPA-CKD) trial, in which researchers showed dapagliflozin with standard therapy can reduce CKD progression and kidney replacement therapy (KRT) requirements, McEwan and colleagues sought to determine the cost-effectiveness of dapagliflozin.
Researchers assumed the payer perspectives in the United Kingdom, Germany and Spain. To characterize outcomes in patients with CKD on the basis of DAPA-CKD, researchers created a lifetime Markov model. They used eGFR level and KRT type to classify health states, and sourced direct heath care costs and utility values from the literature and the DAPA-CKD trial.
Additionally, researchers discounted costs and benefits at 3.5% per annum in the United Kingdom and 3% in Germany and Spain. Researchers conducted subgroup, scenario and sensitivity analyses, as well.
Because patients treated with dapagliflozin were predicted to experience slowed CKD progression, reduced adverse outcomes and increased life expectancy by 1.7 years, researchers identified modeled quality-adjusted life-year (discounted) gains between 0.82 and 1.
Therefore, these gains became incremental cost-effectiveness ratios of $8,280; $$17,623; and $11,687 in the United Kingdom, Germany and Spain, respectively, indicating cost-effectiveness at willingness-to-pay thresholds.
“This study provides a potential blueprint for how the United States could improve affordability of the SGLT2 inhibitors. The Inflation Reduction Act of 2022, signed into law recently by President Biden, grants Medicare an unprecedented ability to negotiate prescription drug pricing starting in 2026,” Annika Khine, MD, from the University of Southern California, and Eugene Lin, MD, MS, from the University of Southern California and member of the Nephrology News and Issues Editorial Advisory Board, wrote in an editorial. “Although SGLT2 inhibitors are not immediately eligible for price negotiations, the law could set the stage for future policies that could make these high-value drugs more affordable and thus, more cost-effective. Still, even at their current price, these drugs remain a tremendous bargain for patients.”
References:
- Dapagliflozin is not only clinically effective, but also cost-effective in patients with chronic kidney disease. https://www.newswise.com/articles/dapagliflozin-is-not-only-clinically-effective-but-also-cost-effective-in-patients-with-chronic-kidney-disease?sc=dwhr&xy=10007438. Published Nov. 2, 2022. Accessed Nov. 2, 2022.
- Khine A, et al. Clin J Am Soc Nephrol. 2022;doi:10.2215/CJN.09900822
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