ArticleEClinicalMedicine2025
Effects of empagliflozin on quality of life and healthcare use and costs in chronic kidney disease: a health economic analysis of the EMPA-KIDNEY trial.
Article in EClinicalMedicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Chronic Kidney Disease (CKD): Systematic Review of the Cost Effectiveness of SGLT2 Inhibitors and Other Novel Nephroprotective Drugs.PharmacoEconomics · 2026Pooled it
- Asymptomatic kidney changes discovered during occupational health screening: age-dependent trends from a large cohort.Clinical kidney journal · 2026Article
- SGLT2 inhibitor role in cardio-metabolic-renal diseases: a narrative review of recent evidence and their pharmacological, clinical and economic implications.Drugs in context · 2026Review
Corrections and comments
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Sodium-glucose co-transporter 2 inhibitors (SGLT2i) slow progression of chronic kidney disease (CKD) but there is no randomised evidence of their effects on health-related quality of life (QoL) and healthcare use. We explored the effects of empagliflozin on health-related QoL, healthcare use and UK healthcare costs in the EMPA-KIDNEY trial. Methods: EMPA-KIDNEY, a randomised, double blind, placebo-controlled, phase 3 trial, was conducted at 241 centres in eight countries (Canada, China, Germany, Italy, Japan, Malaysia, the UK, and the USA), and included participants aged 18 years or older with an estimated glomerular filtration rate (eGFR) of 20 to <45 mL/min/1.73 m Findings: Between May 15, 2019 and April 16, 2021, 6609 participants were randomly assigned to empagliflozin (3304 participants) or matching placebo (3305 participants) in the active-trial which lasted for a median of 2.0 years. Among them, 4891 (74%) were enrolled in the post-trial follow-up. Per participant allocated to empagliflozin over 2 years, total empagliflozin cost was £826 (95% confidence interval: 818 to 835), QALYs were 0.012 higher (0.001 to 0.022), with less cost for hospital admission (-£239, -449 to -29), concomitant medications (-£130, -214 to -47), and management of ESKD (-£208, -414 to -2) compared to placebo. Over a further 2 years of post-trial follow-up off study treatment, there were additional per participant ESKD cost savings (-£842, -1441 to -242), resulting in net total healthcare cost of -£593 (-1384 to 198) over 4 years. The probability of 2 years of empagliflozin treatment being cost-effective at £20 K threshold in the UK was 43% over 2 years of follow-up and 91% over 4 years. The relative effects of empagliflozin on each cost component were similar across categories by baseline levels of eGFR, uACR and diabetes status, with larger reductions in healthcare costs estimated in categories at higher risk of CKD progression. Interpretation: In EMPA-KIDNEY, 2 years treatment with empagliflozin improved QALYs, and reduced use and cost of other healthcare, resulting in high likelihood of cost-effectiveness across a broad range of patients with CKD. The study's key limitation is its relatively short active treatment period and follow-up duration, which may lead to underestimation of the cost-effectiveness of long-term SGLT2i treatment in CKD. Funding: Boehringer Ingelheim, Germany; Eli Lilly, USA; Medical Research Council, UK; British Heart Foundation, UK; Health Data Research, UK; National Institute for Health and Care Research, UK.
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