AMCP Post-Conference Perspectives: Chronic Kidney Disease (CKD) - Episode 2

New Data From AMCP: DAPA-CKD Study

Robert Toto, MD

An expert in chronic kidney disease (CKD) provides an overview of healthcare resource utilization data from the DAPA-CKD study, which was recently released at AMCP.

Robert Toto, MD: With regard to health care resource utilization in the CKD [chronic kidney disease] population, there was a recent poster looking at translating the findings from the DAPA-CKD study, which was a large-scale, randomized, double-blind, placebo-controlled trial in patients with chronic kidney disease who had an estimated GFR [glomerular filtration rate] between 25 and 75. These are people with primarily stage III and some stage IV, and a few stage II chronic kidney disease, and the purpose of the study was to determine whether treatment with dapagliflozin would reduce the likelihood of kidney disease progression to kidney failure, and to examine cardiovascular effects in the study.

The poster is designed to look at the relationship between treatment with dapagliflozin and the health care resource utilization in model. So this not a poster about observational data from the study per se, but rather a model to determine the impact of using dapagliflozin to treat kidney disease compared to placebo on health care resource utilization. I should add that the DAPA-CKD study showed that dapagliflozin in comparison to placebo did significantly reduce kidney failure, it reduced hospitalization for heart failure, and it reduced all-cause mortality. The purpose of this study was to estimate direct medical care costs of a reduced incidence of clinical events associated with dapagliflozin, and the idea was to look at it from a US payer perspective.

The authors of the poster developed a cost-offset model to quantify the short-term predicted clinical and health economic outcomes associated with dapagliflozin treatment in people with CKD, basically those who were in the DAPA-CKD trial. They developed a model with some assumptions of course, which is always necessary doing a model, and they looked at the estimated number of events per outcome per treatment, whether you were on a placebo or dapagliflozin. Then they applied those event-specific costs, the estimated cost per treatment, and then they calculated the outcome-related costs in each group, the placebo group and the Dapagliflozin group. Then they simply did a subtraction between those 2 costs, and that was the basic design of the study in terms of this comparativeness.

Transcript edited for clarity.