BCN HEALTH publishes a systematic review highlighting the cost effectiveness of novel nephroprotective therapies in chronic kidney disease

BCN HEALTH conducted a systematic review to assess and compare the cost effectiveness of recent pharmacological innovations for chronic kidney disease (CKD), with a primary focus on sodium-glucose cotransporter 2 inhibitors (SGLT2i) and a broader assessment of other novel nephroprotective therapies. The review followed PRISMA guidelines and included full-length English-language studies published between January 2015 and September 2025. Search was conducted in PubMed and the Cochrane Library, complemented by searches of health technology assessment and reimbursement agency websites, including NICE. A total of 36 economic evaluations were included, with costs standardized to 2025 US dollars and outcomes assessed in terms of costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs).

The review found that novel nephroprotective therapies are generally cost effective compared with standard of care and, in a substantial number of evaluations, can be cost saving. Across the 36 evaluations, most assessed SGLT2 inhibitors or finerenone, and all reported QALY gains, ranging from 0.012 to 1.44 QALYs. Thirteen evaluations reported cost-saving results, while only three reported an ICER above US$100,000 per QALY. Cost effectiveness was observed both in general CKD populations and among patients with CKD and diabetes, although results varied according to country, healthcare perspective, time horizon, disease severity, and other modelling assumptions.

The economic burden of CKD increased substantially with disease progression. Advanced CKD stages and kidney replacement therapy (KRT), particularly dialysis and transplantation, were consistently identified as the major cost drivers. These findings highlight the economic importance of interventions capable of slowing estimated glomerular filtration rate decline and delaying progression to kidney failure and KRT.

Overall, the systematic review provides updated evidence that novel nephroprotective therapies can deliver substantial health gains while representing good economic value for healthcare systems. The findings support the importance of early adoption of effective treatments to slow CKD progression, delay kidney failure and avoid the high costs associated with dialysis and transplantation. The evidence also highlights the need to consider long-term outcomes when assessing the value of therapies that modify the course of a progressive chronic disease.

More information can be found at https://doi.org/10.1007/s40273-026-01611-6