Evidence map›Paper›PMID 35137296›Full record

ArticleJournal of general internal medicine2022

Cost-Effectiveness of Dapagliflozin for Non-diabetic Chronic Kidney Disease.

Rebecca L Tisdale, Marika M Cusick, Kelly Zhang Aluri, Thomas J Handley, Alice Kate Cummings Joyner, Joshua A Salomon, Glenn M Chertow, Jeremy D Goldhaber-Fiebert, Douglas K Owens

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 3 pooled it
4.7field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 35 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Cost-Effectiveness of Empagliflozin in CKD with or without Albuminuria.Clinical journal of the American Society of Nephrology : CJASN · 2025
    Article
  11. Article
  12. Article
  13. Review
  14. Review
  15. Article
  16. Article
  17. Article
  18. Chronic kidney disease in children: an update.Clinical kidney journal · 2023
    Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Rebecca L TisdaleVA Palo Alto Health Care System (152-MPD), Health Services Research and Development (HSR&D), Center for Innovation to Implementation (Ci2i), 795 Willow Road, Building 324, Menlo Park, CA, 94025, USA. rtisdale@stanford.edu.ORCID 0000-0003-2749-6889
Marika M CusickDepartment of Health Policy, School of Medicine, and Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
Kelly Zhang AluriDepartment of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA.
Thomas J HandleyDepartment of Health Policy, School of Medicine, and Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
Alice Kate Cummings JoynerDepartment of Management Science and Engineering, Stanford University, Stanford, CA, USA.
Joshua A SalomonDepartment of Health Policy, School of Medicine, and Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
Glenn M ChertowDepartment of Health Policy, School of Medicine, and Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
Jeremy D Goldhaber-FiebertDepartment of Health Policy, School of Medicine, and Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
Douglas K OwensDepartment of Health Policy, School of Medicine, and Center for Health Policy, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, USA.
Stanford University · USStanford Medicine · USVA Palo Alto Health Care System · US

Funding

AHRQ HHS T32 HS026128NIDDK NIH HHS K24 DK085446
6 · The paper itself

Abstract

backgroundIn the USA, chronic kidney disease (CKD) affects 1 in 7 adults and costs $100 billion annually. The DAPA-CKD trial found dapagliflozin, a sodium glucose co-transporter 2 (SGLT2) inhibitor, to be effective in reducing CKD progression and mortality in patients with diabetic and non-diabetic CKD. Currently, SGLT2 inhibitors are not considered standard of care for patients with non-diabetic CKD.

objectiveDetermine the cost-effectiveness of adding dapagliflozin to standard management of patients with non-diabetic CKD.

designMarkov model with lifetime time horizon and US healthcare sector perspective. PATIENTS: Patients with non-diabetic CKD

interventionDapagliflozin plus standard care versus standard care only. MAIN MEASURES: Quality-adjusted life years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs), all discounted at 3% annually; total incidence of kidney failure on kidney replacement therapy; average years on kidney replacement therapy. KEY

resultsAdding dapagliflozin to standard care improved life expectancy by 2 years, increased discounted QALYS (from 6.75 to 8.06), and reduced the total incidence of kidney failure on kidney replacement therapy (KRT) (from 17.4 to 11.0%) and average years on KRT (from 0.77 to 0.43) over the lifetime of the cohort. Dapagliflozin plus standard care was more effective than standard care alone while increasing lifetime costs (from $245,900 to $324,8900, or $60,000 per QALY gained). Results were robust to variations in assumptions about dapagliflozin's efficacy over time and by CKD stage, added costs of kidney replacement therapy, and expected population annual CKD progression rates and sensitive to the cost of dapagliflozin. The net 1-year budgetary implication of treating all US patients with non-diabetic CKD could be up to $21 billion.

conclusionsDapagliflozin improved life expectancy and reduced progression of CKD, the proportion of patients requiring kidney replacement therapy, and time on kidney replacement therapy in patients with non-diabetic CKD. Use of dapagliflozin meets conventional criteria for cost-effectiveness.

Indexed as

Diabetes Mellitus, Type 2Renal Insufficiency, ChronicSodium-Glucose Transporter 2 InhibitorsAdultBenzhydryl CompoundsCost-Benefit AnalysisGlucoseGlucosidesHumansQuality-Adjusted Life YearsSodiumSodium-Glucose Transporter 2Benzhydryl CompoundsdapagliflozinGlucoseGlucosidesSodiumSodium-Glucose Transporter 2Sodium-Glucose Transporter 2 Inhibitorschronic kidney diseasecost-effectiveness analysishealth economics

Identifiers

PMID35137296
PMCPMC9551016
OpenAlexW4210858922

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.