Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands
Abstract Background In the Netherlands, more than one million patients have type 2 diabetes (T2D), and approximately 36% of these patients have chronic kidney disease (CKD). Yearly medical costs related to T2D and CKD account for approximately €1.3 billion and €805 million, respectively. The FIDELIO...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12933-023-02053-6 |
| _version_ | 1797416254686887936 |
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| author | Sara W. Quist Alexander V. van Schoonhoven Stephan J. L. Bakker Michał Pochopień Maarten J. Postma Jeanni M. T. van Loon Jeroen H. J. Paulissen |
| author_facet | Sara W. Quist Alexander V. van Schoonhoven Stephan J. L. Bakker Michał Pochopień Maarten J. Postma Jeanni M. T. van Loon Jeroen H. J. Paulissen |
| author_sort | Sara W. Quist |
| collection | DOAJ |
| description | Abstract Background In the Netherlands, more than one million patients have type 2 diabetes (T2D), and approximately 36% of these patients have chronic kidney disease (CKD). Yearly medical costs related to T2D and CKD account for approximately €1.3 billion and €805 million, respectively. The FIDELIO-DKD trial showed that the addition of finerenone to the standard of care (SoC) lowers the risk of CKD progression and cardiovascular (CV) events in patients with CKD stages 2–4 associated with T2D. This study investigates the cost-effectiveness of adding finerenone to the SoC of patients with advanced CKD and T2D compared to SoC monotherapy. Methods The validated FINE-CKD model is a Markov cohort model which simulates the disease pathway of patients over a lifetime time horizon. The model was adapted to reflect the Dutch societal perspective. The model estimated the incremental costs, utilities, and incremental cost-effectiveness ratio (ICER). Sensitivity and scenario analyses were performed to assess the effect of parameter uncertainty on model robustness. Results When used in conjunction with SoC, finerenone extended time free of CV events and renal replacement therapy by respectively 0.30 and 0.31 life years compared to SoC alone, resulting in an extension of 0.20 quality-adjusted life years (QALYs). The reduction in renal and CV events led to a €6136 decrease in total lifetime costs per patient compared to SoC alone, establishing finerenone as a dominant treatment option. Finerenone in addition to SoC had a 83% probability of being dominant and a 93% probability of being cost-effective at a willingness-to-pay threshold of €20,000. Conclusion By reducing the risk of CKD progression and CV events, finerenone saves costs to society while gaining QALYs in patients with T2D and advanced CKD in the Netherlands. |
| first_indexed | 2024-03-09T06:00:45Z |
| format | Article |
| id | doaj.art-f0123344ab7a47149b04a791e10d6a10 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-03-09T06:00:45Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-f0123344ab7a47149b04a791e10d6a102023-12-03T12:09:37ZengBMCCardiovascular Diabetology1475-28402023-11-0122111610.1186/s12933-023-02053-6Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The NetherlandsSara W. Quist0Alexander V. van Schoonhoven1Stephan J. L. Bakker2Michał Pochopień3Maarten J. Postma4Jeanni M. T. van Loon5Jeroen H. J. Paulissen6Department of Health Sciences, University of GroningenDepartment of Health Sciences, University of Groningen Division of Nephrology, Department of Internal Medicine, University Hospital GroningenAssignityDepartment of Health Sciences, University of GroningenValue-XSDepartment of Health Sciences, University of GroningenAbstract Background In the Netherlands, more than one million patients have type 2 diabetes (T2D), and approximately 36% of these patients have chronic kidney disease (CKD). Yearly medical costs related to T2D and CKD account for approximately €1.3 billion and €805 million, respectively. The FIDELIO-DKD trial showed that the addition of finerenone to the standard of care (SoC) lowers the risk of CKD progression and cardiovascular (CV) events in patients with CKD stages 2–4 associated with T2D. This study investigates the cost-effectiveness of adding finerenone to the SoC of patients with advanced CKD and T2D compared to SoC monotherapy. Methods The validated FINE-CKD model is a Markov cohort model which simulates the disease pathway of patients over a lifetime time horizon. The model was adapted to reflect the Dutch societal perspective. The model estimated the incremental costs, utilities, and incremental cost-effectiveness ratio (ICER). Sensitivity and scenario analyses were performed to assess the effect of parameter uncertainty on model robustness. Results When used in conjunction with SoC, finerenone extended time free of CV events and renal replacement therapy by respectively 0.30 and 0.31 life years compared to SoC alone, resulting in an extension of 0.20 quality-adjusted life years (QALYs). The reduction in renal and CV events led to a €6136 decrease in total lifetime costs per patient compared to SoC alone, establishing finerenone as a dominant treatment option. Finerenone in addition to SoC had a 83% probability of being dominant and a 93% probability of being cost-effective at a willingness-to-pay threshold of €20,000. Conclusion By reducing the risk of CKD progression and CV events, finerenone saves costs to society while gaining QALYs in patients with T2D and advanced CKD in the Netherlands.https://doi.org/10.1186/s12933-023-02053-6Cost-effectiveness-analysisChronic kidney diseaseType 2 diabetesCostsQALYsFinerenone |
| spellingShingle | Sara W. Quist Alexander V. van Schoonhoven Stephan J. L. Bakker Michał Pochopień Maarten J. Postma Jeanni M. T. van Loon Jeroen H. J. Paulissen Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands Cardiovascular Diabetology Cost-effectiveness-analysis Chronic kidney disease Type 2 diabetes Costs QALYs Finerenone |
| title | Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands |
| title_full | Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands |
| title_fullStr | Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands |
| title_full_unstemmed | Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands |
| title_short | Cost-effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in The Netherlands |
| title_sort | cost effectiveness of finerenone in chronic kidney disease associated with type 2 diabetes in the netherlands |
| topic | Cost-effectiveness-analysis Chronic kidney disease Type 2 diabetes Costs QALYs Finerenone |
| url | https://doi.org/10.1186/s12933-023-02053-6 |
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