Cost–Utility Analysis of Dapagliflozin as an Add-on to Standard of Care for Patients with Chronic Kidney Disease in Thailand
Issued Date
2022-03-01
Resource Type
ISSN
0741238X
eISSN
18658652
Scopus ID
2-s2.0-85123118863
Pubmed ID
35038121
Journal Title
Advances in Therapy
Volume
39
Issue
3
Start Page
1279
End Page
1292
Rights Holder(s)
SCOPUS
Bibliographic Citation
Advances in Therapy Vol.39 No.3 (2022) , 1279-1292
Suggested Citation
Vareesangthip K. Cost–Utility Analysis of Dapagliflozin as an Add-on to Standard of Care for Patients with Chronic Kidney Disease in Thailand. Advances in Therapy Vol.39 No.3 (2022) , 1279-1292. 1292. doi:10.1007/s12325-021-02037-6 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/86086
Title
Cost–Utility Analysis of Dapagliflozin as an Add-on to Standard of Care for Patients with Chronic Kidney Disease in Thailand
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
Introduction: Chronic kidney disease (CKD) creates a significant economic burden on patients and society. The DAPA-CKD trial reports the benefit of dapagliflozin in CKD patients; however, its cost-effectiveness is unknown in Thailand. This study evaluated the cost–utility of dapagliflozin in addition to standard of care (SoC) compared with SoC alone in CKD patients. Methods: A Markov model was employed to estimate lifetime costs, life-years, and quality-adjusted life-year (QALY), with the modeled population aligned to the baseline characteristics of a DAPA-CKD trial, from a societal perspective. Effectiveness inputs were obtained from the DAPA-CKD trial. Costs and most utility data were gathered from published studies conducted in Thailand. Costs and benefits were discounted at 3% per annum. A series of sensitivity analyses were performed. Results: Over a lifetime horizon, add-on dapagliflozin was estimated to increase life-years by 0.34 and QALY by 0.30 in comparison with SoC alone (7.13 vs. 6.78 years, 5.10 vs. 4.80 QALYs). Total cost was lower under dapagliflozin treatment than SoC treatment (648,413 THB vs. 689,284 THB or 20,947.64 USD vs. 22,268.01 USD). Cost saving occurred as a result of the lower costs of dialysis and KT. The findings were robust to the changes of inputs. Conclusions: On the basis of the DAPA-CKD trial, the add-on dapagliflozin results in cost saving compared favorably with SoC alone in Thailand. The benefit of dapagliflozin in delayed CKD progression is that it reduces the requirement for dialysis and KT, which can offset the costs of dapagliflozin and early CKD treatment.