Chronic Kidney Disease (CKD): Systematic Review of the Cost Effectiveness of SGLT2 Inhibitors and Other Novel Nephroprotective Drugs
Abstract
Background: Chronic kidney disease (CKD) is a major global cause of morbidity and mortality. Recent nephroprotective therapies have improved CKD management, yet their cost effectiveness across settings remains uncertain. This review systematically identified and compared cost-effectiveness studies of novel CKD treatments for both broad CKD populations and disease-specific subgroups.
Methods: A systematic search was conducted in PubMed and the Cochrane Library using terms related to "chronic kidney disease," "cost-effectiveness," "cost-utility," "health technology assessment," "SGLT2 inhibitor," and commercial and generic names of nephroprotective drugs approved since 2013. Eligible studies were full-length articles in English published between January 2015 and September 2025. Costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios were extracted. All monetary values were standardized to 2025 US dollars.
Results: The search yielded 172 records, of which 26 met inclusion criteria. A supplementary search identified ten additional studies, resulting in 36 evaluations. Most studies assessed sodium-glucose cotransporter 2 inhibitors or finerenone. Across evaluations, these therapies consistently improved outcomes, with QALY gains reported in all studies (0.012-1.44 QALYs gained). Most concluded that the interventions were cost effective compared with standard of care, and 13 reported cost-saving results. Only three studies reported an incremental…
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