Adding an SGLT2i (specifically dapagliflozin) to the usual treatment of chronic kidney disease (CKD) with renin-angiotensin-aldosterone system inhibitors could reduce healthcare spending in Spain by 258 million euros in three years for 100,000 patients. This is demonstrated by a study recently published as part of the INSIDE-CKD1 project. “This significant saving corresponds to the reduction in cardiovascular events and the reduction in the risk of entry into dialysis thanks to the nephroprotective and cardioprotective properties of the drug,” explains the Dr. Roberto Alcázar, nephrologist at the Infanta Leonor University Hospital in Madrid and one of the authors of this study. “Concretely, the reduction in the need for renal replacement treatment (dialysis), hospitalization for heart failure and acute renal failure would be respectively 33, 49 and 29%1,” he explains.
Inside CKD2 is an international project funded by AstraZeneca that aims to analyze the prevalence and current and future burdens associated with CKD in countries around the world and simulate intervention strategies to determine their potential impact on health and economic outcomes at national and global scales, enabling data-driven health policies focused on CKD screening and treatment local. “This is the second work of the INSIDE-CKD project applied to Spain,” explains Dr. Alcázar.
The importance of stopping CKD
“It must be taken into account that CKD is a common pathology with increasing prevalence, affecting approximately 15% of the adult population in Spain,” specifies the Dr. Juan Francisco Navarro González, lead author of the study, head of the INVERCAV research group and nephrologist at Nuestra Señora de Candelaria University Hospital (Santa Cruz de Tenerife). It is a progressive disease that determines the progressive loss of kidney function until the implementation of renal replacement treatment (dialysis or transplantation) is necessary, all with a significant negative impact on socially, professionally and on quality of life. Furthermore, CKD is associated with significant morbidity and mortality, mainly cardiovascular. “In fact, projections indicate that if this situation continues, CKD will become the fifth leading cause of death in 2040. The study results Inside-CKD project for Spain “We anticipate a substantial increase in the clinical and economic burden of CKD in the coming years, primarily due to the increasing prevalence of advanced stages of CKD and the disproportionate cost of renal replacement therapy,” warns -he.
These results influence the need to implement strategies aimed at prevention, early diagnosis and proactive and early intervention to reduce progression to the most advanced stages of CKD. “By subtracting the cost of treatment with these drugs from that of reduction in health expenses linked to eventsthe net savings of treatment with the drug added to standard treatment compared to standard treatment alone would be 158 million euros per 100,000 patients treated in 3 years. Thus, for each patient treated with dapagliflozin, there would be a saving of €526.66 per year, compared to standard treatment with renin-angiotensin-aldosterone system inhibitors (RAASI)”, details the Dr. Navarro.
CKD is an underdiagnosed pathology “associated with aging, obesity, smoking, hypertension and diabetes, it is a silent disease which presents symptoms even though it is already very advanced”, he explains. Ana Pérez, Director of Medical and Regulatory Affairs at AstraZenecawhich emphasizes that “within the company we are committed to promoting innovative studies such as Inside-CKD, which seek to better understand chronic kidney disease and thus be able to contribute to the improvement and optimization of healthcare expenses. health and meeting the needs of patients”, which constitute the center of all our actions and which motivate us on a daily basis”, he concludes.
