OBJECTIVES: To quantify the costs and health benefits of the use of dapagliflozin as add on to standard therapy, for the treatment of chronic kidney disease (CKD), from the perspective of Mexican Health System (MHS).

METHODS: According to the DAPA-CKD trial, dapagliflozin showed a significant statistical difference vs placebo, in addition to standard of care, in the composite outcome (a decline of at least 50% in the estimated GRF, the onset of end-stage kidney disease, or death from renal or cardiovascular causes). Due, a cost effectiveness analysis was performed, by a partitioned survival Markov model considering three health states: 1) Free survival progression; 2) Post progression survival; and 3) Death. The time horizon was 15 years, and an annual discount rate of 5% was considered to cost and health benefits. Direct medical cost included in the analysis included cost of acquisition of dapagliflozin, standard of care (including: angiotensin-converting enzyme inhibitors, diuretics, statins, and angiotensin II receptor blockers), hospitalizations, and adverse events management. A deterministic and probabilistic sensitivity analysis was performed.

RESULTS: Dapagliflozin was considered as a dominant alternative, being more effective and less expensive, compared with the standard of care. The addition of dapagliflozin to the standard of care reduce significantly the costs associated to adverse events and worsening of the disease. The results of the sensitivity analysis showed that the results were consistent to the base case.

CONCLUSIONS: The addition of dapagliflozin to the standard of care result in an increase of life years gained and life years free of progression, and a less cost compared with standard of care alone, in the treatment of patients with CKD from the perspective of the MHS.