Health economic modelling of diabetic kidney disease in patients with type 2 diabetes treated with Canagliflozin in Belgium

ABSTRACT

Objectives

The Canagliflozin and Renal Events in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) trial showed reduced renal and cardiovascular (CV) events in patients with type 2 diabetes (T2D) and diabetic kidney disease (DKD) treated with canagliflozin 100 mg added to Standard of Care (SoC) versus SoC alone. This led to an extension of the canagliflozin 100 mg European marketing authorisation, making canagliflozin the first pharmacological therapy to receive authorisation for the treatment of DKD since the RENAAL and IDNT trials more than 20 years ago. Given the importance of cost-effectiveness analyses in health care, this study aimed to leverage the CREDENCE trial outcomes to estimate the cost-effectiveness of canagliflozin 100 mg from the perspective of the Belgian healthcare system.

Methods

A microsimulation model (CREDENCE Economic Model of DKD), developed using patient-level CREDENCE trial data, was leveraged to model the progression of DKD and CV outcomes, associated costs, and life quality. Unit costs and quality-adjusted life years (QALYs) were sourced from the literature. The time horizon was 10 years and sensitivity analyses were performed.

Results

Canagliflozin was associated with sizable gains in life-years and QALYs over 10 years, and the incremental cost-effectiveness ratio cost offsets associated with reductions in CV and renal complications resulted in overall net cost savings from the perspective of the Belgian healthcare system.

Conclusion

Model-based results suggest that adding canagliflozin 100 mg to SoC can improve outcomes for patients with DKD while reducing overall net costs for the Belgian healthcare system.

Graphical Abstract

KEYWORDS:

• Cost-effectiveness
• canagliflozin
• diabetes
• credence
• diabetic kidney disease (DKD)

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole and have given their approval for this version to be published.

Compliance with ethics guidelines

This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Disclosure statement

Michael Willis, and Andreas Nilsson are employees of the Swedish Institute for Health Economics, which provides consulting services for governmental bodies, academic institutions, and commercial life science enterprises (including Mundipharma). Michael Willis is also a minority owner and board member of the Swedish Institute for Health Economics.

Winde Jorissen and Nicolas Louis are employees of Mundipharma.

Lieven Annemans received fees for lectures and advice from Mundipharma.

Data availability

All model inputs used in this study are described or included in this article and the Electronic Supplementary Material (ESM). The economic model used in this study is proprietary intellectual property. For access, please contact Michael Willis ([email protected]).

Additional information

Funding

This work was supported by Mundipharma B.V. Belgium