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Abstract: SA-PO492

Cost-Effectiveness Analysis of Dapagliflozin vs. Finerenone for Diabetic Kidney Disease

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Nava-Vargas, Miriam Gabriela, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Arellano Arteaga, Kevin Javier, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
  • Camacho-Murillo, Luis Agustín, Hospital Regional Valentín Gómez Farias, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Zapopan, Jalisco, Mexico
  • Marquez, Oscar Omar, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
Background

Diabetic kidney disease (DKD) is the leading cause of end-stage chronic kidney disease (CKD) worldwide. CKD carries a health problem public health associated with high morbidity, mortality, high costs and low quality of life. It is necessary to implement risk reduction strategies, such as the use of selective sodium- glucose cotransporter inhibitors 2 (iSGLT2) and selective nonsteroidal mineralocorticoid receptor antagonist (MRA), reducing the risk of 20-40% of time to first onset of kidney failure, sustained decrease in eGFR, and renal or cardiovascular death.

Methods

A probabilistic economic model (Markov model) was developed to evaluate the cost-effectiveness of dapagliflozin versus finerenone for CKD. The model compared patients with dapagliflozin 10 mg per day versus finerenona 20 mg per day, added to standard treatment, in a cohort analyzed at 100 years of age. The states of CKD, progression to CKD with renal replacement therapy (RRT) requirement, renal and cardiovascular death were structured. The effect of dapagliflozin was estimated based on DAPA-CKD trial (HR 0.56; 95% CI, 0.45 - 0.68; p < 0.001) and the effect of finerenone based on FIDELTY trial (HR 0.77; 95% CI, 0.67–0.88; P = 0.0002). Probabilities, benefits, and costs of previous studies reported in literature were collected; to finally calculate the total costs, years of life gained adjusted for quality of life and the cost-effectiveness ratio.

Results

The total difference in cumulative life years was 3,979 for CKD in favor of dapagliflozin use. An incremental cost-effectiveness ratio, expressed in quality-adjusted life years, of $8,907 dollars was estimated with dapagliflozin versus $14,451 dollars with finerenone.

Conclusion

Dapagliflozina is cost-effective treatment versus finerenone for CKD, total difference $ 5,544 dollars for quality-adjusted life year.