OBJECTIVE: Finerenone is a nonsteroidal, selective mineralocorticoid receptor antagonist indicated in adult patients with chronic kidney disease (CKD) with type 2 diabetes (T2D). The objective of this research was to estimate the 3-year financial impact of adding finerenone to the formulary of a U.S. health plan.

METHODS: We developed a budget impact model for a hypothetical 1,000,000-member health plan with both commercial (40%) and Medicare (60%) lives, using the payer perspective and a time horizon of 3 years. Direct costs included drug costs minus patient cost-sharing, and cost offsets for medical outcomes were derived from the cost-effectiveness model developed based on FIDELIO-DKD and FIGARO-DKD clinical trials. Uptake estimates are from Bayer market forecasts. The primary output was incremental budget impact (PMPM) in each year. A one-way sensitivity analysis (OWSA) evaluated the impact of data uncertainty on results.

RESULTS: The commercial population was estimated to have 38 ($0.05 PMPM), 137 ($0.18 PMPM), and 210 ($0.27 PMPM) patients treated with finerenone in years 1, 2, and 3, respectively, and a total (3-year) incremental budget impact of $2,371,000. The Medicare population had 57 ($0.05 PMPM), 205 ($0.19 PMPM), and 315 ($0.28 PMPM) treated patients in years 1, 2, and 3, respectively, and a total budget impact of $3,754,000. A one-way sensitivity analysis indicated that the medical costs for both standard of care and finerenone were key contributors to the financial impact.

CONCLUSION: The addition of finerenone to standard of care resulted in a moderate financial impact for a hypothetical 1,000,000-member health plan with both commercial and Medicare members that is partially offset by reduced medical costs.