OBJECTIVES: To estimate the economic burden of CKD-T2D from a social perspective[1] in two scenarios: the standard of care (SoC) used in Colombia and the standard of care plus Finerenone, a nonsteroidal, selective antagonist of the mineralocorticoid receptor studied for the management of adults with CKD (eGFR ≥ 25mL/min with albuminuria) and T2D.

METHODS: Two CKD-T2D treatment strategies were evaluated, SoC and SoC plus Finerenone, using a Markov model made up of 5 stages of disease development: normoalbuminuria, microalbuminuria, macroalbuminuria, disease end-stage renal disease and death. Costs and DALYs of progression were simulated according to a transition matrix for a cohort of 1000 40 year-old patients with T2D, obtaining the economic burden of the disease for both strategies. Sensitivity analyzes were carried out.

RESULTS: Using an exchange rate of $3.756,67 Colombian pesos per US dollar (USD), the economic burden of the CKD estimated at 2021 prices is $58,28 million dollars for 1,000 people with T2D. Including Finerenone in the micro and macroalbuminuria stages for this cohort increases the direct cost by $ 4,63 million dollars; however, its inclusion generates: reduction in costs of procedures, medicines and supplies (mainly minor dialysis procedures) of 15,7%, lower out-of-pocket expenses of 13,5% and a reduction of DALYs (0,65 years per person) equivalent to a lower loss of productivity of 6,6%.

CONCLUSIONS: The aggregated effect of the inclusion of Finerenone is equivalent to reducing the economic cost of CKD-T2D disease in 1,5% for the cohort analyzed. It is estimated that in this scenario the economic burden of the CKD is $57,40 million dollars for 1,000 people with T2D (equivalent to -$872 thousands of dollars).

[1] Besides the costs assumed by the health system, were considered the costs assumed by households (out of pocket expenses) and the loss of productivity measured with DALY’s and annual income.