Abstract:
UNASSIGNED: Nearly one in ten individuals in South-East Asia are estimated to be affected by chronic kidney disease (CKD). The burden of end-stage kidney disease is significant and can be heavy on the healthcare system. The recent EMPA-KIDNEY trial demonstrated a significant reduction in the risk of kidney disease progression or cardiovascular death in patients with CKD with a broad range of kidney function using add-on empagliflozin versus standard of care (SoC) alone. The objective of this study was to estimate the economic benefit of empagliflozin for patients with CKD in Malaysia, Thailand and Vietnam.
UNASSIGNED: An individual patient level simulation model with an annual cycle that estimates the progression of kidney function and associated risk-factors was employed. Local costs and mortality rates were estimated from a wide range of published literature. A healthcare perspective was used over a 50-year time horizon.
UNASSIGNED: The use of add-on empagliflozin versus SoC alone was found to be cost-saving in Malaysia and Thailand and cost-effective (ICER: 77,838,407 Vietnam Dong/QALY vs. a willingness to pay threshold of 96,890,026/QALY) in Vietnam. The bulk of the costs avoided over a lifetime is derived from the prevention or delay of dialysis initiation or kidney transplant - the cost offsets were nearly twice the additional treatment cost. The results were similar in patients with and without diabetes and across broad range of albuminuria.
UNASSIGNED: The use of add-on empagliflozin in a broad population of patients with CKD is expected to be cost-saving in Malaysia and Thailand and cost-effective in Vietnam and will help alleviate the increasing burden of CKD in the region.
摘要:
背景和目标:据估计,东南亚近十分之一的人受到慢性肾脏病(CKD)的影响。终末期肾脏疾病的负担是巨大的,并且可能对医疗保健系统造成沉重的负担。最近的EMPA-KIDNEY试验表明,使用依帕格列净与单独使用标准护理(SoC)相比,具有广泛肾功能的CKD患者的肾脏疾病进展或心血管死亡风险显着降低。这项研究的目的是评估empagliflozin对马来西亚CKD患者的经济效益。泰国和越南。方法:采用具有年度周期的个体患者水平模拟模型,该模型估计肾功能和相关危险因素的进展。当地的费用和死亡率是根据大量已发表的文献估算的。在50年的时间范围内使用了医疗保健观点。结果:在马来西亚和泰国,发现使用附加的empagliflozin与单独使用SoC可以节省成本,并且具有成本效益(ICER:77,838,407越南东/QALYvs.愿意在越南支付96,890,026/QALY的门槛)。一生中避免的大部分成本来自预防或延迟透析开始或肾移植-成本抵消几乎是额外治疗成本的两倍。在有和没有糖尿病的患者以及广泛的蛋白尿患者中,结果相似。结论:在广泛的CKD患者中使用依帕列净有望在马来西亚和泰国节省成本,在越南具有成本效益,并将有助于减轻该地区CKD日益增加的负担。