Evaluation of clinical events and costs associated with the addition of dapagliflozin to chronic kidney disease treatment: Cost offset analysis.

Autor:	Navarro-González JF; Unidad de Investigación y Servicio de Nefrología, Hospital Universitario Ntra. Sra. de Candelaria, Tenerife, Spain; RICORS2040 (Kidney Disease), Instituto de Salud Carlos III, Madrid, Spain; Instituto de Tecnologías Biomédicas, Universidad de La Laguna, Tenerife, Spain; Facultad de Ciencias de la Salud, Universidad Pernando Pessoa Canarias, Las Palmas de Gran Canaria, Spain., Ortiz A; Servicio de Nefrología e Hipertensión, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain., Cebrián Cuenca A; Medicina Familiar y Comunitaria, Centro de Salud Cartagena Casco Antiguo, Cartagena, Murcia, Spain; Grupo de Atención Primaria, Instituto Murciano de Investigación Biosanitaria (IMIB), Murcia, Spain., Segú L; Unidad de Farmacia Clínica y Farmacoterapia, Facultad de Farmacia, Universidad de Barcelona (UB), Barcelona, Spain., Pimentel B; Departamento Médico, AstraZeneca, Madrid, Spain., Aranda U; Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, United States., Lopez-Chicheri B; Departamento de Acceso al Mercado, AstraZeneca, Madrid, Spain., Capel M; Departamento de Acceso al Mercado, AstraZeneca, Madrid, Spain., Pomares Mallol E; Departamento de Acceso al Mercado, PharmaLex Spain, Barcelona, Spain., Caudron C; Departamento de Acceso al Mercado, PharmaLex Spain, Barcelona, Spain., García Sánchez JJ; Global Market Access & Pricing, BioPharmaceuticals, AstraZeneca, Cambridge, UK. Electronic address: juanjose.garciasanchez@astrazeneca.com., Alcázar Arroyo R; Servicio de Nefrología, Hospital Universitario Infanta Leonor, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Nefrologia [Nefrologia (Engl Ed)] 2024 Dec 06. Date of Electronic Publication: 2024 Dec 06.
DOI:	10.1016/j.nefroe.2024.11.020
Abstrakt:	Background and Objectives: Chronic kidney disease (CKD) is a serious health problem with an increasing clinical, social and economic impact in advanced stages. Dapagliflozin is a sodium-glucose cotransporter-2 inhibitor that reduces the risk of CKD progression, in addition to provide cardiovascular benefits and reduce all-cause mortality. The aim of this study was to determine the short-term clinical and economic impact of dapagliflozin as an add-on to renin-angiotensin-aldosterone system inhibitors (RAASi) standard therapy for CKD in Spain. Materials and Methods: A cost-offset model was used to compare the costs of clinical events and pharmacological per 100,000 CKD patients in a virtual cohort treated with dapagliflozin added to RAASi standard therapy versus RAASi standard therapy alone. Renal (progression to renal failure and acute kidney injury), cardiovascular (hospitalisation for heart failure [HF]), and all-cause mortality events were assessed. The incidence of clinical events by treatment arm was obtained from the DAPA-CKD study, and costs were obtained from national databases and the literature. Results: Over 3 years, treatment with dapagliflozin would reduce progression to renal failure (-33%; 7221 vs. 10,767), hospitalisation for HF (-49%; 2370 vs. 4683) and acute kidney injury (-29%; 4110 vs. 5819). The savings associated with this reduction in events was €258 million per 100,000 patients, of which 63.4% is due to the avoidance of dialysis for renal failure. Considering the event and pharmacological treatment costs, the total net savings were estimated at €158 million per 100,000 patients. Conclusions: Delaying progression of CKD and reducing the incidence of clinical events thanks to the treatment with dapagliflozin could generate savings for the Spanish National Health System, even when pharmacological costs are taken into account. Competing Interests: Declaration of competing interest BL, UA, BLC, MC and JJGS are employees of AstraZeneca. LS, EPM and CC are employees of PharmaLex. AO has received grants from Sanofi and conference or consulting fees or travel expenses from Adviccene, Alexion, Astellas, AstraZeneca, Amicus, Amgen, Boehringer Ingelheim, Fresenius Medical Care, GSK, Bayer, Sanofi-Genzyme, Menarini, Mundipharma, Kyowa Kirin, Lilly, Freeline, Idorsia, Chiesi, Otsuka, Novo-Nordisk, Sysmex and Vifor Fresenius Medical Care Renal Pharma, and is director of the UAM-AstraZeneca Chair of chronic kidney disease and electrolytes, and has shares in Telara Farma. JFNG has been a consultant and/or has received conference fees from AbbVie, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Chiesi, Esteve, Sanofi-Genzyme, Lilly, MSD, Menarini, Mundipharma, Novartis, NovoNordisk, Servier, Shire and Vifor Pharma. RAA has received fees for continuing medical education activities from AstraZeneca, Boehringer-Ingelheim, Lilly, Bayer, Vifor-CSL and Novo-Nordisk, and has served on advisory boards for Boehringer-Ingelheim, AstraZeneca and Bayer. (Copyright © 2024 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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