Cost-utility analysis of simultaneous initiation of finerenone and empagliflozin for type 2 diabetes mellitus complicated with chronic kidney disease.
Finerenone plus empagliflozin is cost-effective versus empagliflozin alone for diabetic kidney disease
Cost-utility analysis of simultaneous initiation of finerenone and empagliflozin for type 2 diabetes mellitus complicated with chronic kidney disease.
Type 2 diabetes mellitus complicated with chronic kidney disease (T2DM-CKD) is a common and severe complication of T2DM that predisposes patients to end-stage renal disease (end-stage renal disease), substantially increasing mortality risk and long-term medical economic burden.
From the perspective of China's healthcare system, this study aimed to evaluate the cost-utility of the simultaneous initiation of finerenone and empagliflozin versus empagliflozin monotherapy in T2DM-CKD patients, based on the CONFIDENCE trial design.
A Markov model was constructed to simulate the natural history of T2DM-CKD.
One-way sensitivity analysis indicated that the kidney disease progression coefficient (which measures the rate of worsening kidney disease) and the cost of finerenone were the most influential parameters; all parameter fluctuations within reasonable ranges retained the cost-effectiveness advantage.
Probabilistic sensitivity analysis showed that the combination regimen was acceptable in 99.1% of 1,000 Monte Carlo simulations (computer-generated scenarios that model uncertainty), with all incremental QALYs positive, indicating highly robust results.
Compared with empagliflozin monotherapy, the combined initiation of finerenone plus empagliflozin offers significant cost-utility advantages in treating T2DM-CKD.
These findings provide high-quality evidence for standardized clinical care, rational pharmacotherapy, the formulation of medical insurance policies, and optimal health resource allocation in Chinese patients with T2DM-CKD.