Abstract
INTRODUCTION: Type 2 diabetes (T2D) is a major cause of chronic kidney disease (CKD) in Japan, and there is an increasing treatment need for first- and second-line care in these patients. The addition of finerenone to current treatment modalities lowers the risk of CKD progression and cardiovascular events in patients with CKD and T2D from the Japanese payer perspective. This study investigated the cost-effectiveness analysis of adding finerenone to standard of care (SoC) versus SoC alone for the treatment of CKD in patients with T2D. METHODS: The FINE-CKD model validated to estimate the cost-effectiveness of finerenone uses the Markov model to simulate the disease pathway of patients over a lifetime horizon. The model was adapted to reflect the Japanese payer perspective and estimated incremental costs, utilities, and incremental cost-effectiveness ratios (ICERs). Sensitivity and scenario analyses were performed to evaluate the effect of the uncertainty of each parameter using a robust model. RESULTS: The quality-adjusted life years (QALYs) for finerenone and SoC were estimated at 9.39 and 9.25, respectively, with an incremental QALY for finerenone for SoC of 0.14. The total cost of finerenone was estimated at ¥ 8,912,601, at an incremental cost of ¥ 274,052, leading to an ICER of ¥ 1,959,516 per QALY gained compared with SoC alone. CONCLUSION: Finerenone in conjunction with SoC is a more cost-effective treatment alternative to SoC alone for adult patients with CKD and T2D from a Japanese healthcare payer perspective.