Pharmacoeconomic analysis of dapagliflozin in patients with chronic kidney disease and type 2 diabetes in the Russian Federation

Abstract

Background. The economic costs associated with chronic kidney disease (CKD) are a significant burden on the health care system. The use of dapagliflozin is a breakthrough strategy in the management of patients with CKD and type 2 diabetes mellitus (T2DM) to slow the progression of the disease and reduce healthcare costs. Aim. To evaluate the clinical and economic efficiency of dapagliflozin in patients with T2DM and CKD in the Russian Federation. Materials and methods. A cost-effectiveness/utility analysis was carried out. The calculation of direct costs was carried out in a model adapted to the conditions of healthcare in the Russian Federation by using Russian cost indicators and characteristics of the patient population. Results. Dapagliflozin in addition to standard therapy compared with standard therapy will provide an additional average of 0.253 life years and 0.219 quality-adjusted life years per patient with stage 2–4 CKD and T2DM during 10 years of therapy. Cost reduction in case of using dapagliflozin and standard therapy compared with standard therapy alone amounted to an average of 49,350 rubles per patient. Dapagliflozin and standard therapy compared with standard therapy alone on the modeling horizon of 10 years allows to extend the stay in the pre-dialysis stages of CKD by an average of 7 months per patient. The use of dapagliflozin in 1000 targeted patients for 10 years will help to avoid 26 hospitalizations for heart failure (NNT – 39), as well as prevent 44 cases of acute kidney injury (NNT – 23) and 51 deaths from all causes (NNT – 20). Probabilistic sensitivity analysis showed the robustness of the results to changes in parameters of cost of therapy, clinical efficacy and usefulness of the studied medical interventions. Conclusion. Intensification of standard CKD therapy with dapagliflozin in patients with T2DM is clinically and economically justified.

Keywords

• chronic kidney disease
• diabetes mellitus
• dapagliflozin
• cost-effectiveness analysis
• cost analysis
• pharmacoeconomic modeling