Pharmacoeconomic impact of empagliflozin in patients with chronic kidney disease

Background. Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce the risk of renal failure in patients with chronic kidney disease (CKD). Objective. To evaluate the pharmacoeconomic impact of empagliflozin in patients with CKD. Material and methods. The economic impact of empagliflozin treatment in adults with CKD was evaluated from the perspective of the Russian health care system under two scenarios: 1) treatment costs for the overall adult CKD population and 2) treatment costs per patient according to the estimated glomerular filtration rate (eGFR). A 10-year time horizon was modeled using R software. Both direct and indirect costs were included. Results. In a population of 18,116.4 thousand patients with CKD and a mean eGFR of 37.3±14.5 ml/min/1.73 m 2 , empagliflozin treatment was projected to reduce the disease burden by 11.95 trillion rubles (−12.1%) over 10 years. Direct costs were projected to decrease by 6.47 trillion rubles (9.8%). In addition, more than 2.4 million cases of disability were projected to be prevented (31.9% reduction), and 479,051 lives were projected to be saved (8.9% increase in survival). Initiating empagliflozin treatment at an eGFR of 37.3±14.5 ml/min/1.73 m 2 was projected to reduce direct costs per patient by 1.4 million rubles (58.9%) over 10 years. Total costs, including direct and indirect costs, were projected to decrease by more than 3.4 million rubles (77.6%). When treatment was initiated at an eGFR of 30.0 ml/min/1.73 m 2 , direct costs were projected to decrease by 5.5 million rubles (84.7%), and total costs by 13.0 million rubles (92.9%). Conclusion. The pharmacoeconomic analysis demonstrates that empagliflozin treatment in patients with CKD is economically justified and appropriate over a medium-term time horizon.