Cost‐effectiveness of sodium‐glucose cotransporter‐2 inhibitors in the treatment of diabetic nephropathy in Japan

• DOI: 10.1111/dom.15832
• Publication Date: 2024-09-30T10:46:09Z
• Authors: Keiko Maruyama‐Sa...; Hisateru Tachimori; Eiko Saito; Shun Kohsaka; Yasumasa Segawa; Hiroaki Miyata; Ataru Igarashi
• Keywords: Canagliflozin; Empagliflozin

Abstract Aim To assess the cost‐effectiveness of diabetic nephropathy treatment with sodium‐glucose cotransporter‐2 (SGLT2) inhibitors in Japanese clinical practice, considering diabetes‐related complications. Materials and Methods A population‐based Monte Carlo simulation was used to estimate for people who initiated pharmacotherapy an SGLT2 inhibitor plus conventional or alone, based on quality‐adjusted life‐years (QALYs) healthcare costs. The Canagliflozin Renal Events Diabetes Established Nephropathy Clinical Evaluation study (CREDENCE) Society Dialysis Research statistical survey were primary sources probability mortality, while Health Insurance Claims Data cost source. state transition model included nephropathy, hospitalization due cardiovascular disease, dialysis, death. One‐way probabilistic sensitivity analyses explore uncertainty. Results Using threshold JPY 5 000 per QALY, more cost‐effective than incremental ratio 654 309 QALY. Treating 100 people, prevented 2234 deaths reduced 5793 fewer heart failure cases, 3967 myocardial infarctions stroke events. Sensitivity analysis affirmed robustness these results patients aged under 70 years. Conclusions appeared be overall population our particularly younger (<70 years old). For older (≥70 old), less clear may require further evaluation. Decision‐makers should consider this age‐based heterogeneity when making recommendations about treatment.