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Abstract: TH-OR60

Earlier Intervention in Diabetic Kidney Disease Management Using the In Vitro Diagnostic Test PromarkerD Shows Economic Health Benefits over Current Standard of Care

Session Information

Category: Diabetic Kidney Disease

  • 702 Diabetic Kidney Disease: Clinical

Authors

  • Peters, Kirsten E., Proteomics International, Perth, Western Australia, Australia
  • Fernandez, Gareth C., Proteomics International, Perth, Western Australia, Australia
  • Chen, Lianzhi, Proteomics International, Perth, Western Australia, Australia
  • Kam, Li Ying, Proteomics International, Perth, Western Australia, Australia
  • Tan, Pearl, Proteomics International, Perth, Western Australia, Australia
  • Lipscombe, Richard, Proteomics International, Perth, Western Australia, Australia
Background

Diabetic kidney disease (DKD) is present in 1 in 3 people with type 2 diabetes (T2D) and is the leading cause of end-stage renal disease (ESRD). PromarkerD is a newly developed biomarker-based blood test that predicts risk of DKD in people with T2D. Recent studies have shown the clinical benefit of early intervention with sodium glucose cotransporter-2 inhibitors (SGLT2s) in DKD management for patients with no or early-stage kidney disease. This study aimed to assess the consequent economic health benefit of earlier introduction of SGLT2s resulting from a proactive testing regime using the PromarkerD test versus current standard of care (SoC).

Methods

A ten-year model was developed according to the International Society of Pharmacoeconomics and Outcomes Research (ISPOR) guidelines to evaluate potential net savings from introducing PromarkerD testing versus SoC in a hypothetical cohort of 1 million people with T2D. Model inputs included costs and frequency of testing, costs associated with initiation of SGLT2s, and cost-savings from slowed DKD progression and averted renal replacement therapy for ESRD (dialysis and kidney transplants).

Results

PromarkerD testing could produce net savings for US payers exceeding $10 billion USD per one million people with T2D over the ten-year time horizon. In the baseline case, the total annual savings equal the costs after four years. Savings increase exponentially in subsequent years, significantly outweighing the associated costs compared to the current SoC without PromarkerD testing. The breakeven point occurs after six years, after which the total savings are greater than the total costs. Significant savings arise from slowing the progression of DKD, against costs from the use of SGLT2s and cost of PromarkerD testing over 10 years.

Conclusion

Earlier intervention with SGLT2s following implementation of the PromarkerD test could result in substantial savings to US payers in the management of DKD. PromarkerD testing would enable earlier intervention for those at high risk of DKD, before progression to more costly later stage disease requiring renal replacement therapy, as well as reduce unnecessary treatment in those at low risk.

Funding

  • Commercial Support – Proteomics International