Clinical efficacy and cost effectiveness of SGLT2i in diabetic nephropathy: a large population-based study
Authors' conclusion
Although SGLT2i demonstrate favorable clinical efficacy and cost-effectiveness, National Health Insurance reimbursement for their use in diabetic nephropathy remains pending, and the potential for genitourinary infections necessitates ongoing clinical vigilance.
Study context
- Population
- Patients with DKD at three medical centers in Taiwan, 2017–2023
- Exposure
- SGLT2i use vs non-use
- Outcome
- Clinical efficacy and cost-effectiveness
- Follow-up
- Median 2.79 years; 10-year model horizon
Methodological detailsInverse probability of treatment weighting (IPTW), multicentre (three medical centers), Markov model, 10-year horizon, 1-year cycle, 3 % discount rate, healthcare payer perspective
- IPTW
- Multicentre (three medical centers)
- Markov model, 10-year horizon, 1-year cycle, 3 % discount rate, healthcare payer perspective
Main finding
As reported in the abstract
Incremental quality-adjusted life years (QALYs) gain
0.70 QALYs
Clinical efficacy and cost-effectiveness
Incremental cost-effectiveness ratio (ICER)
$16,435.71 /QALYs
below willingness-to-pay (WTP) threshold of $32,756
SGLT2i
$38,072
mean · total cost per patient
non-SGLT2i
$26,567
mean · total cost per patient
- Significant improvements in estimated glomerular filtration rate (eGFR) and hemoglobin A1c (HbA1c) with SGLT2i vs non-SGLT2i
- P < 0.05
Observational data: associations, not effects.
Original publication
Clinical efficacy and cost effectiveness of SGLT2i in diabetic nephropathy: a large population-based study. Diabetes Res Clin Pract. Published 22 August 2025. doi:10.
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