Cost-Effectiveness of Empagliflozin in the Treatment of Patients With Chronic Kidney Disease in France

Speaker(s)

Supiot R1, Tardu J2, Virely N1, Sivignon M3, Chollet J2, Uster A4, Levy P5, Massy Z6
1Putnam, Paris, France, 2Boehringer Ingelheim, Paris, France, 3Putnam, Lyon, 69, France, 4Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany, 5Université Paris-Dauphine, Paris, France, 6Association pour l‘Utilisation du Rein Artificiel (AURA), Paris and Department of Nephrology, Ambroise Paré University Medical Center, APHP, Paris, France

Presentation Documents

OBJECTIVES: The efficacy and safety of empagliflozin in the treatment of chronic kidney disease (CKD) were demonstrated in the EMPA-KIDNEY trial which showed a 28% reduction in combined risks of kidney disease or death from cardiovascular causes (Hazard Ratio (HR): 0.72; 95% confidence interval [CI]: 0.64-0.82, p<0.001) compared with placebo. The present study aimed to assess the cost-effectiveness in cost/QALY (quality adjusted life-year) of empagliflozin + standard of care (SoC) compared to SoC alone in the treatment of CKD in France.

METHODS: A Markov microsimulation model with 18 health states was adapted to the French settings to compare the health and economic outcomes from a healthcare system perspective, in patients treated with empagliflozin in addition to SoC versus SoC alone. For each arm and over a time horizon of 25 years, the model estimated: events, life-years, QALYs, and costs to calculate the Incremental Cost-Effectiveness Ratio (ICER). Patients’ characteristics, clinical, quality of life, and costs inputs were derived from the French CKD-REIN cohort, EMPA-KIDNEY trial, French authorities reports, French CKD guidelines, and literature. Both economic and health outcomes were discounted at a 2.5% annual rate according to French guidelines.

RESULTS: The model predicted that the treatment of CKD patients with empagliflozin + SoC would prevent CKD related complications and deaths associated with a cardiovascular event or all-cause deaths during kidney replacement therapy, resulting on average in a discounted higher gain in overall survival and accumulated QALYs. Overall, empagliflozin + SoC would lead to a higher gain in QALYs while being less costly than SoC alone and would therefore be the dominant treatment strategy. The sensitivity analyses conducted support the results’ robustness of the dominance of empagliflozin + SoC over SoC alone.

CONCLUSIONS: This study shows that empagliflozin + SoC is a dominant strategy compared to the current SoC for the management of CKD in France.

Code

HTA63

Topic

Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health, Patient-Centered Research

Topic Subcategory

Comparative Effectiveness or Efficacy, Cost-comparison, Effectiveness, Utility, Benefit Analysis, Patient-reported Outcomes & Quality of Life Outcomes, Public Health

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Urinary/Kidney Disorders