Abstract: TH-PO1015
Cost-Effectiveness of Empagliflozin in CKD in a Real-World US Population
Session Information
- CKD: Epidemiology, Risk Factors, and Prevention - 1
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Chatterjee, Satabdi, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
- Al Rawashdh, Neda, IQVIA Inc, Falls Church, Virginia, United States
- Anaya, Pablo, IQVIA Inc, Falls Church, Virginia, United States
- Uster, Anastasia, Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany
- Aguirre Mazo, Anna Rita, Boehringer Ingelheim International GmbH, Ingelheim, Rheinland-Pfalz, Germany
- Ramos, Mafalda, Th(is)2modeling, Asse, Flemish Brabant, Belgium
- Gerlier, Laetitia, IQVIA Belgium, Zaventem, Vlaams Brabant, Belgium
- Lamotte, Mark, Th(is)2modeling, Asse, Flemish Brabant, Belgium
Background
Studies have established the cost-effectiveness of empagliflozin (EMPA) on top of standard of care (SoC) in patients similar to the EMPA-KIDNEY population (wide range of patients with CKD, with or without diabetes) and have shown benefits of timely EMPA initiation from a US payer perspective. In the current study the cost-effectiveness of EMPA and the consequences of delaying EMPA, in a real-world population of patients with CKD was assessed.
Methods
Using a patient-level state transition model that defined health states by KDIGO categories, simulated patients were tracked over a lifetime horizon. 2020 US Renal Data System data were used to populate demographics, CKD stages (40.3% G1, 19.8% G2, 28.6% G3a, 7.9% G3b, 2.4% G4, 1.0% G5), and comorbidities (e.g., 51.7% diabetes, 61.2% cardiovascular disease). The model used published cohort studies to predict disease progression, complications, and death; EMPA-KIDNEY trial data for treatment effects; and literature for drug costs, complication, and adverse events management costs and utilities. Life years (LY), quality-adjusted LY (QALY), and incremental cost-effectiveness ratios (ICERs) were estimated at a willingness to pay (WTP) threshold of $150,000/QALY. Scenario analyses compared delaying initiation of EMPA by 1, 3, and 5 years vs. SoC alone with the base case (no EMPA delay).
Results
In base case analyses, use of EMPA+SoC delayed disease progression to ESKD or death by 1.21 years, and resulted in 0.50 LYs and 0.47 QALYs gained vs. SoC only. The increased effectiveness came with higher costs for both payers ($20,393 for commercial payers and $42,152 for Medicare), however, ICERs ($43,898/QALY for commercial and $90,737/QALY for Medicare) were cost-effective at the WTP threshold. Delaying EMPA initiation reduced the clinical benefits and increased the incidence of progression to ESKD and the need to initiate kidney replacement therapy; a longer delay in initiation further reduced benefits. Additionally, delaying EMPA therapy did not result in significant savings to either commercial or Medicare payers.
Conclusion
Findings confirm the cost-effectiveness of EMPA in a real-world population of individuals with CKD for US commercial and Medicare payers, and provide evidence of benefits with timely initiation of EMPA.
Funding
- Commercial Support – Boehringer Ingelheim Pharmaceuticals