Impact of SGLT2-Inhibitor Uptake in CKD Management in Denmark: A Decision Economic Model
Author(s)
Renee Olesen, MHS1, Nicholas Carlson, Ph.D., Cand. Med.2, Jens Søndergaard, Ph.D., Cand. Med.3, Ellen Linnea Freese Ballegaard, Ph.D., Cand. Med.2, Rikke Borg, Ph.D., Cand. Med.4, Lars Holger Ehlers, Ph.D., MS5.
1Nordic Institute of Health Economics, Aarhus, Denmark, 2Rigshospitalet, Copenhagen, Denmark, 3University of Southern Denmark, Odense, Denmark, 4Copenhagen University, Copenhagen, Denmark, 5Nordic Institute of Health Economics, Aarhus C, Denmark.
1Nordic Institute of Health Economics, Aarhus, Denmark, 2Rigshospitalet, Copenhagen, Denmark, 3University of Southern Denmark, Odense, Denmark, 4Copenhagen University, Copenhagen, Denmark, 5Nordic Institute of Health Economics, Aarhus C, Denmark.
OBJECTIVES: Chronic kidney disease (CKD) poses an increasing global burden for patients and healthcare providers driven aging populations and rising prevalence of chronic diseases. Despite strong evidence supporting benefits of sodium-glucose co-transporter 2-inhibitors (SGLT2i), uptake remains limited. This study models potential benefits of increased SGLT2i uptake on clinical and economic outcomes of CKD in Denmark.
METHODS: Incident and prevalent CKD populations eligible for SGLT2i were simulated using a validated CKD progression model to assess attributable 10-year effects of SGLT2i treatment associated with uptake rates of 15%, 50%, and 90%. SGLT2i treatment effects were estimated based on outcomes in the EMPA-KIDNEY trial. Based on population estimates for CKD G3-G5, the model evaluated benefit on all-cause mortality, quality-adjusted life years, cardiovascular disease, and kidney failure (KF). The broader healthcare impact was estimated through costs and net monetary benefit.
RESULTS: Based on prevalence and incidence of CKD, the model predicts a 30% increase in the population of CKD G3-G5 from 251,946 in 2026 to 328,414 in 2035. SGLT2i uptake of 15%, 50%, 90% are associated with a 10-year risks of KF of 8.5%, 6.6%, and 4.5% respectively and 10-year mortality rate of 54.3%, 53.9% and 53.5%. This results in a net monetary benefit of 204 and 438 million €, respectively, compared to uptake of 15%.
CONCLUSIONS: Based on a validated CKD progression model, increased SGLT2i uptake in Denmark is associated with increased patient survival and reduced progression to KF leading to a net benefit on health care spending within a six-year time horizon.
METHODS: Incident and prevalent CKD populations eligible for SGLT2i were simulated using a validated CKD progression model to assess attributable 10-year effects of SGLT2i treatment associated with uptake rates of 15%, 50%, and 90%. SGLT2i treatment effects were estimated based on outcomes in the EMPA-KIDNEY trial. Based on population estimates for CKD G3-G5, the model evaluated benefit on all-cause mortality, quality-adjusted life years, cardiovascular disease, and kidney failure (KF). The broader healthcare impact was estimated through costs and net monetary benefit.
RESULTS: Based on prevalence and incidence of CKD, the model predicts a 30% increase in the population of CKD G3-G5 from 251,946 in 2026 to 328,414 in 2035. SGLT2i uptake of 15%, 50%, 90% are associated with a 10-year risks of KF of 8.5%, 6.6%, and 4.5% respectively and 10-year mortality rate of 54.3%, 53.9% and 53.5%. This results in a net monetary benefit of 204 and 438 million €, respectively, compared to uptake of 15%.
CONCLUSIONS: Based on a validated CKD progression model, increased SGLT2i uptake in Denmark is associated with increased patient survival and reduced progression to KF leading to a net benefit on health care spending within a six-year time horizon.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE542
Topic
Clinical Outcomes, Economic Evaluation, Epidemiology & Public Health
Disease
Urinary/Kidney Disorders