Abstract

Chronic kidney disease (CKD) is a costly public health issue, with an estimated prevalence of 13.4% globally. Anemia is a common complication associated with CKD resulting in reduced health-related quality of life and high healthcare costs. The objective of this analysis was to estimate the direct medical care cost offsets of investigational agent roxadustat for the treatment of anemia in patients with non-dialysis dependent (NDD) CKD from a Canadian healthcare perspective. Data from the roxadustat global Phase 3 program were used to estimate the projected incidence of rescue therapy use (intravenous iron, erythropoiesis stimulating agents or red blood cell transfusions) and major adverse cardiovascular events-plus (MACE+) for roxadustat compared to standard of care (placebo) in NDD patients with anemia of CKD. MACE+ events included myocardial infarction, stroke, hospitalized unstable angina, hospitalized congestive heart failure, cardiovascular death, and other death. Published Canadian cost data were used to estimate the cost of each medical event. A hypothetical cohort of 10,000 NDD Canadian patients with anemia of CKD aged 18 years and older was modeled with net medical care cost offsets calculated in Canadian dollars for each of the five years and cumulatively. Patients who transitioned to dialysis during the time horizon of the analysis were also evaluated in this cost offsets analysis. Compared to standard of care, preliminary results of the model for patients with NDD CKD and patients who transitioned to dialysis during the five year horizon of the analysis showed that roxadustat could produce net medical care cost offsets resulting from the reductions in rescue therapy usage and reduction in MACE+ events (specifically hospitalizations due to HF). Cumulative medical care cost offsets for patients with NDD CKD and patients who transitioned to dialysis during the five year horizon of the analysis compared with standard of care were estimated for rescue therapy use ($1,428,501) and MACE+ ($1,496,865). This cost offsets analysis provides evidence that treatment with roxadustat, in NDD patients with anemia of CKD and patients who transition to dialysis, could result in lower total medical care net costs compared to the costs of standard of care.

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