Journal of nephrology · 2026
Healthcare cost offsets associated with empagliflozin for the treatment of chronic kidney disease in Italy: a budget impact analysis.
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De Nicola Luca, Reboldi Gianpaolo, Fioretto Paola, Pontremoli Roberto, Uster Anastasia, Di Costanzo Alessandra, Vassallo Chiara
Аннотация
BACKGROUND: Empagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, was recently approved for reimbursement in patients with chronic kidney disease (CKD) in Italy. This budget impact analysis (BIA) aimed to evaluate the direct health-care costs of managing CKD in Italian clinical practice, before and after the introduction of empagliflozin as an add-on to the current standard of care.
METHODS: The budget impact analysis was conducted using a prevalence model based on a static cost calculator approach. The analysis population included adults eligible to receive add-on empagliflozin for CKD in Italy. Costs considered were those associated with treatment acquisition, CKD management, hospitalizations, and progression to kidney failure (KF). The model adopted the perspective of the Italian National Health Service (NHS) and a 3-year time horizon.
RESULTS: Introducing add-on empagliflozin for CKD in Italy was estimated to reduce direct health-care costs by 4.7% and generate a total cost saving of €10.09 million over 3 years (total health-care costs of €216.07 million in a current scenario without empagliflozin vs €205.98 million in the future scenario with empagliflozin). Cost savings were driven by an increase in the number of patients who may be treated with SGLT2 inhibitors due to EMPA-KIDNEY clinical trial evidence for patients with urinary albumin-to-creatinine ratio <200 mg/g, and thereby reducing the number of those progressing to KF. Deterministic sensitivity analyses reaffirmed that introducing empagliflozin would be cost saving to the Italian NHS.
CONCLUSIONS: By delaying disease progression in a wider CKD population than has been addressed in previous clinical trials with other SGLT2 inhibitors, the introduction of empagliflozin constitutes a promising strategy to reduce the clinical and economic burden of CKD as a whole in the Italian context.
METHODS: The budget impact analysis was conducted using a prevalence model based on a static cost calculator approach. The analysis population included adults eligible to receive add-on empagliflozin for CKD in Italy. Costs considered were those associated with treatment acquisition, CKD management, hospitalizations, and progression to kidney failure (KF). The model adopted the perspective of the Italian National Health Service (NHS) and a 3-year time horizon.
RESULTS: Introducing add-on empagliflozin for CKD in Italy was estimated to reduce direct health-care costs by 4.7% and generate a total cost saving of €10.09 million over 3 years (total health-care costs of €216.07 million in a current scenario without empagliflozin vs €205.98 million in the future scenario with empagliflozin). Cost savings were driven by an increase in the number of patients who may be treated with SGLT2 inhibitors due to EMPA-KIDNEY clinical trial evidence for patients with urinary albumin-to-creatinine ratio <200 mg/g, and thereby reducing the number of those progressing to KF. Deterministic sensitivity analyses reaffirmed that introducing empagliflozin would be cost saving to the Italian NHS.
CONCLUSIONS: By delaying disease progression in a wider CKD population than has been addressed in previous clinical trials with other SGLT2 inhibitors, the introduction of empagliflozin constitutes a promising strategy to reduce the clinical and economic burden of CKD as a whole in the Italian context.