ESTIMATED RENAL AND CARDIOVASCULAR OUTCOMES AND COST OFFSETS IN PATIENTS WITH TYPE 2 DIABETES (T2D) AND DIABETIC NEPHROPATHY (DKD) TREATED WITH CANAGLIFLOZIN

Author(s)

Willis M1, Durkin M2, Neslusan C2, Traina S3, Nilsson A1
1The Swedish Institute for Health Economics, Lund, Sweden, 2Janssen Scientific Affairs, LLC, Titusville, NJ, USA, 3Janssen Global Services, LLC, Raritan, NJ, USA

OBJECTIVES: Based on renal and cardiovascular benefits demonstrated in the CREDENCE trial, canagliflozin (CANA) received a novel indication to reduce the risk of end-stage kidney disease (ESKD), doubling of serum creatinine, cardiovascular death, and hospitalization for heart failure (HHF) in patients T2D and DKD with albuminuria >300 mg/day. As CANA is the first new pharmacotherapy for this population in nearly two decades, economic stakeholders are unfamiliar with assessing the cost offsets associated with treatment. The purpose of this study was to use an economic microsimulation model to estimate health outcomes and cost offsets associated with CANA versus standard of care (SOC) in this patient population from a US payer perspective.

METHODS: The economic model, CREDEM-DKD, was built with patient-level data from CREDENCE and includes risk equations for the following events: HHF, start of dialysis, non-fatal myocardial infarction (MI), non-fatal stroke, and all-cause mortality. Equations for estimated glomerular filtration rate (eGFR) and urinary albumin:creatinine ratio (UACR) evolution were used to capture DKD progression. The model was loaded with baseline characteristics and treatment effects from CREDENCE. Unit costs were sourced from literature and inflated to $2018. In the base case, health trajectories were simulated over 5 years for 1,000 cohorts of 1,000 hypothetical patients. Sensitivity analyses were performed.

RESULTS: In the base case, treatment with CANA versus SOC was associated with 20% fewer dialysis starts; 36%, 16%, and 18% fewer HHF, MI, and stroke events, respectively; and 0.08 life-years gained. The largest estimated 5-year cost-offsets were for dialysis and HHF at about $4,000 and $1,000 per patient, respectively, increasing to approximately $7,700 and $1,500, respectively, in the 10-year simulation.

CONCLUSIONS: Results of these simulations suggest that for this high unmet need patient population, treatment with CANA will result in fewer renal, cardiovascular, and mortality events and sizable cost offsets.

Conference/Value in Health Info

2020-05, ISPOR 2020, Orlando, FL, USA

Code

PDB26

Topic

Economic Evaluation

Topic Subcategory

Trial-Based Economic Evaluation

Disease

Diabetes/Endocrine/Metabolic Disorders

Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now

×