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达格列净治疗慢性肾脏病患者的短期成本:一项回顾性队列研究。

Short-term costs in patients with chronic kidney disease treated with dapagliflozin: a retrospective cohort study.

机构信息

Department of Internal Medicine, University of Utah Health, Salt Lake City, UT, USA.

US Evidence, US Medical Affairs, AstraZeneca, Wilmington, DE, USA.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(9):1057-1066. doi: 10.1080/14737167.2023.2237679. Epub 2023 Aug 4.

Abstract

OBJECTIVES

This real-world study evaluated the impact of dapagliflozin on short-term medical costs in patients with stage 3 chronic kidney disease (CKD).

METHODS

This retrospective, observational cohort study used medical and pharmacy claims data from IQVIA PharMetrics Plus. Patients aged ≥18 years with a filled dapagliflozin prescription after stage 3 CKD diagnosis between September 2020 and December 2021 were 1:1 propensity score matched with patients with stage 3 CKD who did not receive dapagliflozin. The primary endpoint was cardiorenal medical costs to payers over 6 months; all-cause medical and pharmacy costs were also analyzed. Within the overall population, there was a new-user subgroup of patients with no sodium-glucose co-transporter-2 use during baseline.

RESULTS

The new-user subgroup included 503 matched patients per cohort. Mean per-patient cardiorenal medical costs were reduced by 49.0% in the dapagliflozin versus non-dapagliflozin cohort ($3172.15 vs $6219.50;  < 0.001). Mean all-cause medical costs were reduced ($8043.58 vs $12,194.87;  < 0.001) and mean all-cause pharmacy costs were increased ($9056.98 vs $7453.23;  = 0.22). Results were similar for the overall population.

CONCLUSION

This study showed dapagliflozin was associated with reduced cardiorenal medical costs over 6 months compared with no dapagliflozin treatment in patients with stage 3 CKD, demonstrating real-world medical cost savings.

摘要

目的

本真实世界研究评估了达格列净对 3 期慢性肾脏病(CKD)患者短期医疗成本的影响。

方法

这是一项回顾性、观察性队列研究,使用了 IQVIA PharMetrics Plus 的医疗和药房理赔数据。2020 年 9 月至 2021 年 12 月期间,在确诊 3 期 CKD 后使用达格列净处方的年龄≥18 岁的患者,与未使用达格列净的 3 期 CKD 患者,按照 1:1 倾向评分匹配。主要终点是 6 个月内向支付方支付的心血肾医疗成本;还分析了全因医疗和药房成本。在总体人群中,存在一个无钠-葡萄糖共转运蛋白-2(SGLT-2)使用的新用户亚组,该亚组在基线时有 503 名匹配患者。达格列净组与非达格列净组的每位患者心血肾医疗成本分别降低了 49.0%(3172.15 美元比 6219.50 美元; < 0.001)。全因医疗成本降低(8043.58 美元比 12194.87 美元; < 0.001),全因药房成本增加(9056.98 美元比 7453.23 美元; = 0.22)。总体人群的结果相似。

结论

本研究表明,与未使用达格列净相比,在 3 期 CKD 患者中,达格列净治疗可降低 6 个月内的心血肾医疗成本,证明了实际医疗成本的节约。

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