Abstract

 The CADTH Formulary Management Expert Committee (FMEC) concluded there was an unmet need to reduce the progression of chronic kidney disease (CKD), especially for those patients without diabetes, given the lack of reimbursed options.
 Evidence from the DAPA-CKD trial, the largest trial with the longest follow-up identified by a systematic review, demonstrated that patients with CKD treated with dapagliflozin had a slower decline of estimated glomerular filtration rate, a reduction in the urinary albumin to creatinine ratio, and increased time to cardiovascular and renal events compared with placebo.
 FMEC concluded that reimbursement should be restricted to patients eligible for the DAPA-CKD trial, which included meeting diagnostic criteria for CKD and treatment with an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker at the maximum-tolerated dose.
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