Exploring the Potential Health Economic Value of the Aldosterone Synthase inhibitor and Sodium Glucose Transporter 2 inhibitor Combination in Chronic Kidney Disease
Author(s)
Mafalda Ramos, MSc1, Mark Lamotte, MD2, Radek Wojcik, MSc3, Villum Wittrup-Jensen, MSc3, Sven-Oliver Tröbs, MD4, Juliane Meyerhoff, MD3, Peter Rossing, MD5, Katherine R. Tuttle, MD6;
1Th(is)²Modeling, Asse, Belgium, 2Th(is)²Modeling, Cardiologist - Health economic specialist, Asse, Belgium, 3Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany, 4Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Denmark, 5Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Copenhagen, Denmark, 6Providence Inland Northwest Health, Spokane, WA, USA
1Th(is)²Modeling, Asse, Belgium, 2Th(is)²Modeling, Cardiologist - Health economic specialist, Asse, Belgium, 3Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Germany, 4Boehringer Ingelheim International GmbH, Ingelheim am Rhein, Denmark, 5Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Copenhagen, Denmark, 6Providence Inland Northwest Health, Spokane, WA, USA
Presentation Documents
OBJECTIVES: Chronic Kidney Disease (CKD) represents a clinical and economic challenge, with annual healthcare expenditures amounting to £7 billion in the UK alone, primarily driven by kidney replacement therapy and hospitalizations. The phase-2-trial (NCT05182840) demonstrated up to 40% urine albumin-creatinine ratio (uACR) reduction, highlighting the potential therapeutic value of the aldosterone synthase inhibitor vicadrostat (10mg) combined with empagliflozin (SGLT2 inhibitor). This study investigates the economic and clinical potential of this novel therapeutic combination to reduce healthcare costs through improved patient outcomes.
METHODS: A previously validated CKD progression model, used in health technology assessments across multiple countries, projected the long-term impact of uACR changes on outcomes and costs. uACR data were derived from a 14-week phase-2-trial, assessing various doses of vicadrostat or matching placebo on a background therapy of empagliflozin or matching placebo. All participants received an ACE-inhibitor or ARB (standard of care, SoC). No impact of the treatment on estimated glomerular filtration rate (eGFR) was assumed, the model incorporated eGFR decline for the current uACR based on CRIC registry data. The base-case analysis was conducted for the UK, using 3.5% annual discount rates and a lifelong time horizon, assuming a 3-year treatment duration. UK default utilities and complication costs were used. Treatment costs were not applied.
RESULTS: Among the doses tested, 10mg vicadrostat+empagliflozin+SoC showed the largest reductions in uACR. Compared to empagliflozin+SoC, the model projected potential cost savings of £3,443 with vicadrostat+empagliflozin+SoC, primarily driven by delayed kidney replacement therapy. Compared to empagliflozin+SoC, the model projected gains of 0.24 life-years and 0.29 quality-adjusted life-years with vicadrostat+empagliflozin+SoC.
CONCLUSIONS: The simulation modeling suggests the vicadrostat+empagliflozin combination may offer a promising new option in CKD treatment with meaningful cost savings for health systems through improved patient outcomes and avoidance of complications. Clinical outcomes of the ongoing phase 3 trial (EASi-KIDNEY™, NCT06531824) will be essential to confirm these findings.
METHODS: A previously validated CKD progression model, used in health technology assessments across multiple countries, projected the long-term impact of uACR changes on outcomes and costs. uACR data were derived from a 14-week phase-2-trial, assessing various doses of vicadrostat or matching placebo on a background therapy of empagliflozin or matching placebo. All participants received an ACE-inhibitor or ARB (standard of care, SoC). No impact of the treatment on estimated glomerular filtration rate (eGFR) was assumed, the model incorporated eGFR decline for the current uACR based on CRIC registry data. The base-case analysis was conducted for the UK, using 3.5% annual discount rates and a lifelong time horizon, assuming a 3-year treatment duration. UK default utilities and complication costs were used. Treatment costs were not applied.
RESULTS: Among the doses tested, 10mg vicadrostat+empagliflozin+SoC showed the largest reductions in uACR. Compared to empagliflozin+SoC, the model projected potential cost savings of £3,443 with vicadrostat+empagliflozin+SoC, primarily driven by delayed kidney replacement therapy. Compared to empagliflozin+SoC, the model projected gains of 0.24 life-years and 0.29 quality-adjusted life-years with vicadrostat+empagliflozin+SoC.
CONCLUSIONS: The simulation modeling suggests the vicadrostat+empagliflozin combination may offer a promising new option in CKD treatment with meaningful cost savings for health systems through improved patient outcomes and avoidance of complications. Clinical outcomes of the ongoing phase 3 trial (EASi-KIDNEY™, NCT06531824) will be essential to confirm these findings.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE191
Topic
Economic Evaluation
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Urinary/Kidney Disorders