Presentation (CTI)

OBJECTIVES: To estimate the costs avoided from a social perspective by the inclusion of Finerenone approved for the management of adults with CKD (eGFR ≥ 25 mL/min with albuminuria) and T2D, including the costs avoided from HF hospitalization and the progression of chronic kidney disease
METHODS: Two strategies were evaluated: standard treatment (i.e., ACEi and ARBs) versus standard treatment plus Finerenone, using a Markov model associated to the stages of disease progression. To estimate the effect of including Finerenone on reduction of hospitalization due to heart failure, the FIDELITY study was used, in which a Hazard Ratio of 0,78 was observed. Hospitalization probabilities for HF were calculated for each stage of renal disease and adjusted for Finerenone. Then, hospitalization costs were weighted with these probabilities. Also, we used the outcome from FIDELITY study for renal results. An annual cost of Finerenone of USD$634 per patient/year was considered. Using a Markov model, costs and Disability-Adjusted Life Years (DALYs) were simulated for each strategy and stage of the disease, with a transition matrix for a cohort of 1.000 patients aged 40 with Type 2 Diabetes (T2D)
RESULTS: Using an exchange rate of COP$4.061 Colombian pesos per US dollar (USD), economic burden of CKD and T2D at 2024 prices for every 1.000 people with T2D was USD$78.428 . Including Finerenone in the stages for micro and macroalbuminuria reduces 20,3% the costs of procedures, medications, and supplies (mainly due to dialysis), 16,2% hospitalization costs for heart failure, 16,1% out-of-pocket expenses, and 8,5% productivity loss, equivalent to 0,89 DALYs per person/year. With the inclusion of Finerenone, the total economic burden is USD$73.948 per patient
CONCLUSIONS: The inclusion of Finerenone reduces the economic burden of CKD in T2D associated with hospitalization due to HF in 5,7%, equivalent to USD $4.480 per patient in time horizon of 37 years