Pharmacoeconomic evaluation of dapagliflozin and empagliflozin in the treatment of type 2 diabetic kidney disease
- VernacularTitle:达格列净与恩格列净治疗2型糖尿病肾病的药物经济学评价
- Author:
Xu YANG
1
;
Yifan ZHAO
1
;
Wanting LI
1
;
Yongjun LIU
1
Author Information
1. School of International Pharmaceutical Business，China Pharmaceutical University，Nanjing 211198，China
- Publication Type:Journal Article
- Keywords:
dapagliflozin;
empagliflozin;
cost-utility;
Markov model;
type 2 diabetic kidney disease
- From:
China Pharmacy
2025;36(18):2285-2290
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the cost-effectiveness of dapagliflozin and empagliflozin in the treatment of type 2 diabetic kidney disease from the perspective of healthcare system in China. METHODS Based on the data from the two multicenter clinical trials， DECLARE-TIMI 58 and EMPA-REG OUTCOME， a Markov model was constructed according to the urinary albumin-to-creatinine ratio （UACR） of the patients with type 2 diabetic kidney disease with a cycle of 1 year， simulating until 99% of patients died. The model outputs were total costs and quality-adjusted life year （QALY）. The cost-effectiveness of the two treatment regimens was assessed by comparing their incremental cost-effectiveness ratio （ICER） and the willingness-to-pay threshold （WTP，set at three times China’s 2023 per capita gross domestic product， i.e.， 268 074 yuan/QALY）. Additionally， oneway sensitivity analysis and probabilistic sensitivity analysis were performed to test the robustness of the base analysis results. RESULTS Compared with dapagliflozin， the ICER for empagliflozin regimen was 44 334.82 yuan/QALY， which was below the WTP ， indicating its cost-effectiveness. The results of the oneway sensitivity analysis indicated that the incidence of non-fatal myocardial infarction in both groups and the utility values associated with the microalbuminuria state had the most significant impact on the outcomes， but did not change the base-case conclusion. The probabilistic sensitivity analysis indicated that the results of the base-case analysis were robust. CONCLUSIONS With a WTP of three times China’s per capita gross domestic product in 2023， empagliflozin is more cost-effective than dapagliflozin in treating type 2 diabetic kidney disease.
