Cost-effectiveness of finerenone added to standard of care for patients with type 2 diabetes-related chronic kidney disease in the United States.

IF 5.4 2区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes, Obesity & Metabolism Pub Date : 2024-10-08 DOI:10.1111/dom.15997

Cailin Zheng, Jinneng Wu, Na Li, Xiaoxia Wei, Zhixiong Huang, Lingbin Chen, Zhou Chen

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引用次数: 0

Abstract

Aim: To examine the cost-effectiveness of adding finerenone to standard of care (SoC) for treating type 2 diabetes mellitus (T2DM)-related chronic kidney disease (CKD) in the United States.

Materials and methods: Based on the clinical data analysed by FIDELITY, we referenced the validated FINE-CKD model (Markov model) to evaluate the cost-effectiveness of SoC versus SoC + finerenone from the perspective of US payers. The model was cycled for 35 years in 4-month cycles, with cost and utility values derived from the published literature. The primary outcomes were incremental cost-effectiveness ratio (ICER) and quality-adjusted life years (QALYs). Deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of the base-case results.

Results: The treatment strategy of finerenone plus SoC led to gains of 6.95 QALYs and had a lifetime cost of $491 745.31. Compared to SoC, that strategy yielded 0.48 more QALYs at an added cost of $65 305.72. The ICER for finerenone was $135 257.06 per QALY, which is below the willingness-to-pay threshold of United States ($150 000/QALY). The results were sensitive to the hazard ratios associated with the efficacy of finerenone and its cost. Probabilistic sensitivity analyses showed that the probability that finerenone plus SoC would be cost-effective was 57.6%.

Conclusions: For patients with T2DM-related CKD, adding finerenone to SoC may be a cost-effective option in the United States. Reasonable price reductions for finerenone could potentially benefit more patients.

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美国 2 型糖尿病相关慢性肾病患者标准治疗中添加非格列酮的成本效益。

目的：研究在美国治疗 2 型糖尿病（T2DM）相关慢性肾病（CKD）的标准护理（SoC）中添加非格列酮的成本效益：根据 FIDELITY 分析的临床数据，我们参考了经过验证的 FINE-CKD 模型（马尔可夫模型），从美国支付方的角度评估了 SoC 与 SoC + 非格列酮的成本效益。该模型以 4 个月为周期循环 35 年，成本和效用值来自已发表的文献。主要结果是增量成本效益比 (ICER) 和质量调整生命年 (QALY)。进行了确定性和概率敏感性分析，以评估基础病例结果的稳健性：非格列酮加 SoC 的治疗策略可获得 6.95 QALYs 的收益，终生成本为 491 745.31 美元。与 SoC 相比，该策略的 QALYs 增加了 0.48 个，成本增加了 65 305.72 美元。非格列酮的 ICER 为 135 257.06 美元/QALY，低于美国的支付意愿阈值（150 000 美元/QALY）。研究结果对非内瑞酮疗效和成本的相关危险比很敏感。概率敏感性分析表明，非格列酮加 SoC 具有成本效益的概率为 57.6%：结论：在美国，对于 T2DM 相关性 CKD 患者而言，在 SoC 中添加非格列酮可能是一种具有成本效益的选择。非格列酮的合理降价有可能使更多患者受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes, Obesity & Metabolism 医学-内分泌学与代谢

CiteScore

10.90

自引率

6.90%

发文量

319

审稿时长

3-8 weeks

期刊介绍： Diabetes, Obesity and Metabolism is primarily a journal of clinical and experimental pharmacology and therapeutics covering the interrelated areas of diabetes, obesity and metabolism. The journal prioritises high-quality original research that reports on the effects of new or existing therapies, including dietary, exercise and lifestyle (non-pharmacological) interventions, in any aspect of metabolic and endocrine disease, either in humans or animal and cellular systems. ‘Metabolism’ may relate to lipids, bone and drug metabolism, or broader aspects of endocrine dysfunction. Preclinical pharmacology, pharmacokinetic studies, meta-analyses and those addressing drug safety and tolerability are also highly suitable for publication in this journal. Original research may be published as a main paper or as a research letter.