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논문분류	춘계학술대회 초록집
제목	Cost-Effectiveness of Dapagliflozin as a Treatment for Chronic Kidney Disease Among Patients With Diabetes in China
저자	Fengyu Wen
출판정보	2025; 2025(1):
키워드	chronic kidney disease, diabetic kidney disease, cost-effectiveness, dapagliflozin, health economics
초록	Patients with diabetes are at increased risk of developing chronic kidney disease (CKD). Dapagliflozin has been demonstrated to slow CKD progression and reduce the risk of cardiovascular disease (CVD) and mortality. However, the introduction of novel medications inevitably increases treatment costs. Currently, evidence regarding the cost-effectiveness of dapagliflozin for CKD among patients with diabetes in Asian populations remains limited. This study therefore aimed to evaluate its cost-effectiveness among patients with diabetes in China. We developed a microsimulation model based on high-quality data sources to simulate lifetime costs and disease progression for a cohort of 10,000 patients with diabetes from a societal perspective. The primary outcomes included the incremental cost-effectiveness ratio (ICER), quality-adjusted life years (QALYs), kidney failure with replacement therapy (KFRT), and CVD. These outcomes were estimated as weighted averages across four age-specific diabetic cohorts (45-year-old, 55-year-old, 65-year-old, 75-year-old). To better capture the variability of real-world clinical practice, scenario analyses were conducted to explore different levels of patient adherence to dapagliflozin treatment. Compared with standard CKD treatment alone, adding dapagliflozin decreased lifetime KFRT incidence by 16.38 per 1,000 individuals and lifetime CVD incidence by 8.11 per 1,000 individuals. Furthermore, dapagliflozin yielded an additional 1.096 life years and 0.537 QALYs, with an incremental cost of $1,087. The ICER of dapagliflozin was $2,026 per QALY gained, which was below the willingness-to-pay threshold in China. Scenario analyses indicated that higher adherence to dapagliflozin treatment yielded greater health benefits, with treatment consistently remaining cost-effective across different adherence levels. For patients with diabetes, incorporating dapagliflozin into standard CKD treatment can increase life years, reduce the incidence of KFRT and CVD, and is likely to be cost-effective in China.
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