A recent study in the Canadian Journal of Kidney Health and Disease suggests a class of drugs called SGLT2 inhibitors would offer significant health improvements for BC kidney patients and would also lower related health-care costs substantially for the province. The results helped prompt the BC Ministry of Health to fund the medications, which have been proven to reduce kidney patients’ risk of dialysis and death, for eligible patients in the province.
SGLT2 inhibitors were originally designed, tested and prescribed for people with diabetes. Early studies of SGLT2 inhibitors in this population included some people who also had kidney disease and suggested these medications could also improve kidney function and avoid kidney failure. This was recently proven in three major international trials over the past few years.
Dr. Tae Won Yi is a nephrologist with the University of British Columbia who wanted to explore how the results of these major clinical trials in other regions of the world might benefit kidney patients in BC.
“When major studies are published like that, we want to apply them to the patient sitting in front of us,” explains Yi. “So we looked at how many of our kidney patients would be eligible for SGLT2 inhibitors, based on the criteria from these other trials, to see how many of them could similarly benefit from these medications.”
To do so, Yi’s team turned to BC Renal’s information system known as PROMIS, which contains data on roughly 18,000 kidney patents across the province. Their analysis suggests that about 17% – or more than 3,100 – of these patients would potentially benefit from taking a SGLT2 inhibitor.
Next, the researchers did a high-level cost analysis to understand whether funding the drug could result in cost savings. Notably, dialysis is a very costly therapy, at roughly $100,000 per patient per year. Therefore any medication that prevents or delays kidney patients from needing dialysis has great potential to lower health-care costs – and even more importantly greatly improve the quality of life of patients.
Their analysis shows that, if all eligible kidney patients in BC were given the SGLT2 inhibitor canagliflozin, this could potentially save the province $2.31 million within the first 2.6 years. A second, more in-depth cost analysis is underway to get more of an understanding of the potential savings. In the meantime, when BC Renal presented the results of this study to the BC Ministry of Health, they agreed that the results were compelling and supported the importance of ensuring kidney patients’ access to SGLT2 inhibitors.
Yi notes that several years ago, it was only diabetes patients without or with kidney disease who would be covered for this type of medication, as a last resort when other therapies failed.
“But now we have the medication covered for kidney patients without diabetes, so I think that is a fantastic first step to improving patient care,” he says.