Cost-Effectiveness Analysis of SGLT2 Inhibitors for Cardio-Renal-Metabolic Disease Based on Data from Japanese Studies

IF 3.4 3区医学 Q2 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Therapy Pub Date : 2025-04-29 DOI:10.1007/s12325-025-03157-z

Ataru Igarashi, Hisateru Tachimori, Keiko Maruyama-Sakurai, Yasumasa Segawa, Hiroyuki Takagi, Hiroki Akiyama, Naohiko Imai, Shun Kohsaka, Hiroaki Miyata

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引用次数: 0

Abstract

Introduction

Cardiovascular, renal, and metabolic diseases, collectively known as cardio-renal-metabolic (CRM) disease, interact and exacerbate each other, creating serious clinical and economic burdens. Sodium–glucose cotransporter 2 inhibitors (SGLT2i) are important therapeutic agents in managing CRM disease. Despite proven clinical benefits, the economic benefits of SGLT2i in the management of CRM diseases remain unclear.

Methods

We developed Markov models representing the natural progression of disease for two populations: a type 2 diabetes mellitus (T2DM) population and non-diabetic chronic kidney disease (non-DM CKD) population. These models incorporated key complications, including heart failure, myocardial infarction, stroke, CKD (for the T2DM population), and end-stage renal disease. A systematic literature search was conducted to determine input parameters. For each model, we estimated the 10-year medical costs, quality-adjusted life years (QALY), and incremental cost-effectiveness ratio (ICER) for SGLT2i treatment compared with conventional treatment. A probabilistic sensitivity analysis (PSA) and scenario analyses with conservative assumptions were performed.

Results

In the base-case analysis, SGLT2i treatment was estimated to increase QALY by 0.177 (7.090 vs 6.913 QALY; T2DM population) and 0.457 (6.980 vs 6.523 QALY; non-DM CKD population), and increase total medical costs by Japanese yen (JPY) 99,060 (JPY 762,524 vs 663,463; T2DM population) and JPY 229,810 (JPY 3,378,873 vs 3,149,063; non-DM CKD population), compared with conventional treatment. The ICER was JPY 559,175/QALY in the T2DM population and JPY 503,123/QALY in the non-DM CKD population. The PSA revealed that the probability of ICER being below the threshold value of JPY 5,000,000/QALY was 100% in the T2DM population and 98.7% in the non-DM CKD population, and the ICERs were below this threshold in all scenario analyses.

Conclusion

SGLT2i treatment was demonstrated to be cost-effective in both the T2DM population and the non-DM CKD population, suggesting the potential of SGLT2i to offer significant clinical and economic benefits in the comprehensive management of CRM diseases.

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基于日本研究数据的SGLT2抑制剂治疗心肾代谢性疾病的成本-效果分析

导读：心血管、肾脏和代谢性疾病统称心肾代谢性疾病，它们相互作用、相互加剧，造成了严重的临床和经济负担。钠-葡萄糖共转运蛋白2抑制剂（SGLT2i）是治疗CRM疾病的重要药物。尽管已证实有临床益处，但SGLT2i在CRM疾病管理中的经济效益仍不清楚。方法：我们为2型糖尿病（T2DM）人群和非糖尿病性慢性肾脏疾病（非dm CKD）人群建立了代表疾病自然进展的马尔可夫模型。这些模型纳入了主要并发症，包括心力衰竭、心肌梗死、中风、慢性肾病（针对T2DM人群）和终末期肾病。通过系统的文献检索来确定输入参数。对于每个模型，我们估计了与常规治疗相比，SGLT2i治疗的10年医疗成本、质量调整生命年（QALY）和增量成本-效果比（ICER）。进行了概率敏感性分析（PSA）和保守假设情景分析。结果：在基本病例分析中，SGLT2i治疗估计使QALY增加0.177 (7.090 vs 6.913 QALY；2型糖尿病人群)和0.457(质量质量：6.980 vs 6.523；非糖尿病CKD人群)，总医疗费用增加99,060日元（JPY） (JPY 762,524 vs 663,463；2型糖尿病人群)和229,810日元(3,378,873日元vs 3,149,063日元；非糖尿病性CKD人群)，与常规治疗相比。2型糖尿病人群ICER为559,175日元/QALY，非糖尿病CKD人群ICER为503,123日元/QALY。PSA显示，2型糖尿病人群ICER低于500万日元/QALY阈值的概率为100%，非糖尿病CKD人群ICER低于该阈值的概率为98.7%，所有情景分析中ICERs均低于该阈值。结论：SGLT2i治疗在T2DM人群和非dm CKD人群中均具有成本效益，提示SGLT2i在CRM疾病的综合管理中具有显著的临床和经济效益。

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

Advances in Therapy 医学-药学

CiteScore

7.20

自引率

2.60%

发文量

353

审稿时长

6-12 weeks

期刊介绍： Advances in Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Advances in Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.