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Kidney Week

Abstract: FR-PO1128

Budget Impact Analysis for Empagliflozin in Patients with Nondiabetic CKD

Session Information

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, Belgium
  • Gerlier, Laetitia, IQVIA Belgium, Zaventem, Vlaams Brabant, Belgium
  • Lamotte, Mark, Th(is)2Modeling, Asse, Belgium
Background

In a wide range of patients with chronic kidney disease (CKD) with and without diabetes enrolled in EMPA-KIDNEY, empagliflozin (EMPA) on top of standard of care (SoC) showed favorable effects on kidney disease progression or cardiovascular death. Our previous research established the cost-effectiveness of adding EMPA to SoC in these patients. This study assessed the budget impact of integrating EMPA into a US commercial payer formulary, and focused on the non-diabetic patients, as they constitute majority of the CKD population.

Methods

In a hypothetical plan covering 1 million lives, data on CKD prevalence, use of angiotensin converting enzyme inhibitors [ACEis] or angiotensin receptor blockers [ARBs] in CKD, and prevalence of diabetes in CKD were used to estimate number of EMPA-eligible patients in non-diabetic CKD. The baseline market utilization was 100% for ACEi/ARB and 0% for dapagliflozin and EMPA. The projected utilization of EMPA and dapagliflozin for years 1-5 were estimated from internal sources (EMPA: 0.17% in year 1 to 19.24% in year 5; dapagliflozin: 2.60% in year 1 to 13.81% in year 5). Drug costs were based on published wholesale acquisition costs; dosing data was obtained from product prescribing information. The annual average costs of treating one patient with EMPA+SoC and comparators were derived from our previous research that included costs of drugs, complications and disease progression management costs. Model results were reported for total budget impact, per member per month (PMPM), and per patient per month (PPPM) costs for each year and cumulatively for years 1-5.

Results

Adding newer therapies such as EMPA to SoC for non-diabetic CKD yielded a net budget impact of -$155,557,417 (-1.83%), -$2.59 in PMPM and -$96.66 PPPM for a commercial payer over five years. This was driven by savings in year 3 and onwards, with $34 million reduction in year 3, $76 million reduction in year 4, and $55 million reduction in year 5, attributable to the reduced expenses for kidney replacement therapies for patients on EMPA compared to SoC alone.

Conclusion

Overall, findings suggest cost savings with adding newer therapies such as EMPA in non-diabetic CKD for commercial payers, and provide evidence on value of EMPA in this high unmet need population.

Funding

  • Commercial Support – Boehringer Ingelheim Pharmaceuticals