Abstract: SA-PO887
Translating the Findings of DAPA-CKD to Reductions in Healthcare Resource Utilization and Costs
Session Information
- CKD: Clinical Trials and Pharmacoepidemiology
November 05, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials
Authors
- McEwan, Philip, Health Economics and Outcomes Research Ltd, Cardiff, United Kingdom
- Miller, Ryan, Health Economics and Outcomes Research Ltd, Cardiff, United Kingdom
- Garcia Sanchez, Juan Jose, AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
- Barone, Salvatore, AstraZeneca R&D, Gaithersburg, Maryland, United States
- Nolan, Stephen, AstraZeneca PLC, Cambridge, Cambridgeshire, United Kingdom
- Jha, Vivekanand, The George Institute for Global Health, Newtown, New South Wales, Australia
- Correa-Rotter, Ricardo, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Mexico
- Chernin, Gil, Kaplan Medical Center, Rehovot, Israel
- De Nicola, Luca, Universita degli Studi della Campania Luigi Vanvitelli Scuola di Medicina e Chirurgia, Napoli, Italy
Background
Dapagliflozin reduced the risk of kidney failure and all cause, including cardiovascular, mortality in CKD patients with and without type 2 diabetes in the Study to Evaluate the Effect of Dapagliflozin and Prevention of Adverse Outcomes in Chronic Kidney Disease (DAPA-CKD). The trial was stopped early due to overwhelming efficacy, with a 39% reduction in the incidence of the primary composite endpoint (≥50% eGFR decline, end-stage kidney disease (ESKD) and renal/cardiovascular death). This project aimed to estimate the impact on healthcare resource use and costs.
Methods
Event rates in dapagliflozin and placebo arms of the DAPA-CKD trial were used to predict the incidence of components of trial endpoints over a three-year period. Cost-offsets versus standard of care without dapagliflozin (SOC) were estimated by applying published US costs to the incidence of events. Those attributed to a ≥50% decline in eGFR were based on the resulting CKD stage compared with baseline CKD stage. Dapagliflozin costs were excluded. Results were estimated in a treated population of 10,000 people. Analysis of 10,000 people aged <65 years and 10,000 people ≥65 years was also conducted. Results for the USA will be supplemented with further analysis for a total of 32 countries.
Results
Over a three-year period, the estimation predicted 750 cases of ≥50% decline in eGFR with dapagliflozin versus 1,340 with SOC (590 fewer events, number needed to treat [NNT]: 17). 355 ESKD events would be avoided with dapagliflozin (722 vs 1,077, NNT: 28) as would 231 hospitalisations for heart failure (HHF) compared with SOC (237 vs 468, NNT: 43) and 249 deaths (638 vs 887, NNT: 40). Reduced incidences of adverse clinical outcomes were estimated to give cumulative medical care cost-offsets of $126.9M per 10,000 treated patients, $223.0M per 10,000 treated patients aged <65 years and $61.9M per 10,000 treated patients aged ≥65 years, or 34%, 38%, and 25% reductions compared with SOC, respectively.
Conclusion
Dapagliflozin treatment in CKD has the potential to significantly reduce healthcare resource use through delayed CKD progression and reduced incidence of cardio-renal events and mortality.
Funding
- Commercial Support –