Qiu Tingting, Li Ping, Yan Dan
Beijing Institute of Clinical Pharmacy, Beijing Friendship Hospital of Capital Medical University, No. 95, YongAn Road, Beijing, 10050, China.
Department of Public Health, Aix-Marseille University, Marseille, France.
Clin Drug Investig. 2025 Jul 14. doi: 10.1007/s40261-025-01462-7.
Dapagliflozin and empagliflozin are emerging as promising treatment options for diabetic kidney disease (DKD).
This study sought to evaluate the cost effectiveness of incorporating dapagliflozin and empagliflozin into the standard treatment for DKD in China.
A Markov model was constructed to evaluate the cost-effectiveness of dapagliflozin and empagliflozin plus standard treatment versus standard treatment alone for DKD treatment from a healthcare perspective. Costs and utility data was obtained from published literatures within the Chinese context. The primary outcome included total cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). GDP per capita of 2023 in China (¥89,358) was utilized as the willingness-to-pay threshold.
Compared to standard treatment alone, add-on therapy of dapagliflozin or empagliflozin resulted in a higher total cost than those solely receiving standard treatment (+¥19,203.56 and +¥9496.92, respectively). However, both dapagliflozin and empagliflozin also yielded more life-years (+1.72 vs. +1.40) and QALYs (+1.40 vs. +0.88). The ICER per life-year and ICER per QALY was ¥11,178.52 and ¥18,192.50 for dapagliflozin and ¥6773.10 and ¥10,811.64 for empagliflozin, respectively. The incremental net monetary benefit was ¥75,120.54 and ¥68,994.90 for dapagliflozin and empagliflozin, respectively. Sensitivity analysis supported the main findings of the base-case analysis as the cost-effectiveness of dapagliflozin or empagliflozin was sustained for most plausible ranges of parameter values.
Considering that the ICER falls below the predefined willingness-to-pay threshold, incorporating dapagliflozin and empagliflozin into standard treatment for DKD is likely to be a cost-effective strategy in China.
达格列净和恩格列净正成为治疗糖尿病肾病（DKD）的有前景的治疗选择。
本研究旨在评估在中国将达格列净和恩格列净纳入DKD标准治疗的成本效益。
构建马尔可夫模型，从医疗保健角度评估达格列净和恩格列净加标准治疗与单独标准治疗相比治疗DKD的成本效益。成本和效用数据来自中国背景下已发表的文献。主要结局包括总成本、质量调整生命年（QALY）和增量成本效益比（ICER）。采用2023年中国的人均国内生产总值（89358元）作为支付意愿阈值。
与单独的标准治疗相比，达格列净或恩格列净的附加治疗导致总成本高于单纯接受标准治疗的患者（分别增加19203.56元和9496.92元）。然而，达格列净和恩格列净也都带来了更多的生命年（分别为+1.72对+1.40）和QALY（分别为+1.40对+0.88）。达格列净每生命年的ICER和每QALY的ICER分别为11178.52元和18192.50元，恩格列净分别为6773.10元和10811.64元。达格列净和恩格列净的增量净货币效益分别为75120.54元和68994.90元。敏感性分析支持了基础病例分析的主要结果，因为在大多数合理的参数值范围内，达格列净或恩格列净的成本效益得以维持。
考虑到ICER低于预先定义的支付意愿阈值，在中国将达格列净和恩格列净纳入DKD标准治疗可能是一种具有成本效益的策略。
