J Med Econ. 2025 Dec;28(1):2103-2118. doi: 10.1080/13696998.2025.2590401. Epub 2025 Dec 2.
ABSTRACT
AIMS: The global prevalence of cardio-renal-metabolic (CRM) conditions, including chronic kidney disease, heart failure, type 2 diabetes in interconnected pathophysiology, is rapidly increasing. This presents health/economic consequences for Asia-Pacific (APAC) countries experiencing substantial disease burden. We aimed to forecast the regional clinical/economic burden of comorbid CRM conditions and evaluate the potential impact of sodium-glucose cotransporter 2 (SGLT2) inhibitors on burden reduction, with empagliflozin as the modeled intervention.
METHODS: A Markov model (10-year time horizon [2024-2033]; annual cycle length) was developed and adapted for selected Southeast Asian countries (Malaysia/the Philippines/Thailand/Vietnam/Singapore), Australia, and South Korea using published local epidemiological and economic data. Future CRM disease prevalence, as well as the modeled SGLT2 inhibitor empagliflozin's potential in reducing clinical burden (prevalence/mortality) and associated healthcare resource use (HCRU) costs, were estimated. Empagliflozin cost was excluded from HCRU calculations to isolate/evaluate the economic burden of CRM conditions.
RESULTS: Projecting the current disease trends (without SGLT2 inhibitors), the total number of patients with comorbid CRM conditions and deaths in Southeast Asia/Australia/South Korea would increase ∼3-fold from 19.0 million/968,000/2.6 million (2024) to 63.4 million/3.1 million/7.1 million (2033). Guideline-recommended use of SGLT2 inhibitor empagliflozin is estimated to prevent 925,000/19,100/105,000 patients from developing comorbid conditions and ∼1.9 million/50,000/174,000 deaths in Southeast Asia/Australia/South Korea by 2033. After excluding empagliflozin cost, these reductions translate to discounted cumulative cost savings for Southeast Asia (Malaysia: RM16.9 billion/the Philippines: ₱775.6 billion/Thailand: ฿973.7 billion/Vietnam: 148.0 trillion ₫/Singapore: S$1.1 billion), Australia (AU$23.2 billion), and South Korea (₩42.4 trillion). Varying the parameters of the deterministic sensitivity analysis resulted in upper and lower estimates of economic burden that differed by no more than 10% from the mean economic burden of each health state across the seven APAC countries.
LIMITATIONS: Underreporting/variability in local epidemiological data potentially affected burden projection accuracy. Insufficient available data on comorbid CRM conditions across countries necessitated model input assumptions, which may have introduced uncertainties.
CONCLUSIONS: Substantial increases in comorbid CRM disease prevalence and associated healthcare resource strain in APAC are expected over the next decade. Guideline-directed SGLT2 inhibitor use, with empagliflozin as an example, may alleviate regional clinical and economic burden.
PMID:41329235 | DOI:10.1080/13696998.2025.2590401