Real-World Uptake of SGLT2i Usage in Patients With Chronic Kidney Disease or Heart Failure: A German Claims Data Analysis
Author(s)
Nils Kossack, Dipl.-Math1, Marco Müller, PhD1, Ines Weinhold, PhD1, Marc Pignot, PhD, MSc2, Michael Schultze, Dr., Staatsexamen Tiermedizin2, Dennis Häckl, MA, PhD3.
1WIG2 Institute, Leipzig, Germany, 2ZEG Berlin – Center for Epidemiology and Health Research, Berlin, Germany, 3Leipzig University, Leipzig, Germany.
1WIG2 Institute, Leipzig, Germany, 2ZEG Berlin – Center for Epidemiology and Health Research, Berlin, Germany, 3Leipzig University, Leipzig, Germany.
OBJECTIVES: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) were initially approved for glycemic control in type 2 diabetes but have since shown significant cardiovascular and renal benefits. Recent guideline updates and regulatory approvals have extended their indications to include the treatment of chronic kidney disease (CKD) and heart failure (HF), irrespective of diabetes status. This analysis aims to quantify the uptake of SGLT2i therapy in patients diagnosed with CKD or HF between 2019 and 2023.
METHODS: We analyzed claims data from the WIG2 Benchmark Database, which includes approximately 4 million individuals insured under Germany’s statutory health insurance (SHI) system, to derive cross-sectional estimates of SGLT2i use in patients with CKD or HF. Patients diagnosed with CKD or HF were selected and examined for the presence of SGLT2i prescriptions. To ensure national representativeness, estimates were directly standardized by age and gender for each year from 2019 to 2023.
RESULTS: While estimated patient numbers for Germany remained relatively stable between 2019 and 2023 for both the CKD and HF populations (in 2023: CKD: 4.2 million, HF 4.1: million), the use of SGLT2i increased substantially in both populations. Among CKD patients, the proportion receiving SGLT2i rose from 4.5% to 21.9%; in HF, from 3.6% to 25.9%. The strongest year-on-year growth occurred between 2021 and 2022, coinciding with the publication of significant results from major clinical trials and updated guideline recommendations.
CONCLUSIONS: Since the expansion of SGLT2i indications to include CKD and HF, real-world uptake has increased but has not yet reached its full potential. As of 2023, only around one in five CKD or one in four HF patients are treated with SGLT2i, highlighting a significant gap between evidence-based recommendations and clinical practice. Targeted strategies to improve clinician awareness, prescription behavior, and patient access are needed to fully translate the proven cardiovascular and renal benefits into routine care.
METHODS: We analyzed claims data from the WIG2 Benchmark Database, which includes approximately 4 million individuals insured under Germany’s statutory health insurance (SHI) system, to derive cross-sectional estimates of SGLT2i use in patients with CKD or HF. Patients diagnosed with CKD or HF were selected and examined for the presence of SGLT2i prescriptions. To ensure national representativeness, estimates were directly standardized by age and gender for each year from 2019 to 2023.
RESULTS: While estimated patient numbers for Germany remained relatively stable between 2019 and 2023 for both the CKD and HF populations (in 2023: CKD: 4.2 million, HF 4.1: million), the use of SGLT2i increased substantially in both populations. Among CKD patients, the proportion receiving SGLT2i rose from 4.5% to 21.9%; in HF, from 3.6% to 25.9%. The strongest year-on-year growth occurred between 2021 and 2022, coinciding with the publication of significant results from major clinical trials and updated guideline recommendations.
CONCLUSIONS: Since the expansion of SGLT2i indications to include CKD and HF, real-world uptake has increased but has not yet reached its full potential. As of 2023, only around one in five CKD or one in four HF patients are treated with SGLT2i, highlighting a significant gap between evidence-based recommendations and clinical practice. Targeted strategies to improve clinician awareness, prescription behavior, and patient access are needed to fully translate the proven cardiovascular and renal benefits into routine care.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH206
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Urinary/Kidney Disorders