Hsuan-Hui Wang , Yi-Wen Chiu , Cheng-Yin Chung , Yu-Mei Liao , Yung-Heng Lee , Han-Ming Kuo , Hon-Yi Shi
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引用次数: 0
Abstract
Objective
To evaluate the clinical efficacy and cost-effectiveness of SGLT2i versus non-use in routine care for diabetic nephropathy.
Methods
A retrospective cohort study was conducted analyzing patients diagnosed with diabetic kidney disease at three medical centers in Taiwan between 2017 and 2023. Inverse probability of treatment weighting (IPTW) minimized selection bias. The maximum follow-up period for clinical outcomes was 5.9 years, with a median duration of 2.79 years. A Markov model with a 10-year horizon, 1-year cycle, and 3 % discount rate assessed cost-effectiveness from the healthcare payer perspective.
Results
SGLT2i use was associated with statistically significant improvements in estimated glomerular filtration rate (eGFR) and hemoglobin A1c (HbA1c) compared to non-SGLT2i treatment (p < 0.05). Mean total cost per patient was $38,072 for the SGLT2i group and $26,567 for the non-SGLT2i group. The incremental quality-adjusted life years (QALYs) gain was 0.70, resulting in an incremental cost-effectiveness ratio (ICER) of $16,435.71/QALYs. This value was well below the established willingness-to-pay (WTP) threshold of $32,756, indicating favorable cost-effectiveness.
Conclusions
Although SGLT2i demonstrate favorable clinical efficacy and cost-effectiveness, National Health Insurance reimbursement for their use in diabetic nephropathy remains pending, and the potential for genitourinary infections necessitates ongoing clinical vigilance.
期刊介绍:
Diabetes Research and Clinical Practice is an international journal for health-care providers and clinically oriented researchers that publishes high-quality original research articles and expert reviews in diabetes and related areas. The role of the journal is to provide a venue for dissemination of knowledge and discussion of topics related to diabetes clinical research and patient care. Topics of focus include translational science, genetics, immunology, nutrition, psychosocial research, epidemiology, prevention, socio-economic research, complications, new treatments, technologies and therapy.