Dapagliflozin May Be Cost-Effective for Chronic Kidney Disease, Review Finds

A systematic review published in Cost Effectiveness and Resource Allocation on 6 October 2026 concludes that most existing economic evaluations suggest dapagliflozin, added to standard treatment, may be more cost-effective than standard of care alone for chronic kidney disease (CKD). The review, led by Zehui Jiang and colleagues, systematically searched Chinese and English databases—including PubMed, Web of Science, Embase, the Cochrane Library, CNKI, Wanfang Data and Chongqing VIP—as well as health technology assessment agency websites including NICE, CADTH, PBAC and HITAP, up to 28 July 2026.

The analysis included 14 studies of acceptable overall quality, covering 12 countries: China, the United States, Japan, the United Kingdom, Spain, Germany, Canada, Kuwait, Malaysia, Colombia, Italy and Thailand. The included studies were assessed using the CHEERS and Drummond checklists, standard appraisal tools for reporting and methodological quality in economic evaluations. The review is registered with PROSPERO under CRD420251179322.

Across the included studies, most suggested that dapagliflozin combined with standard treatment may be more cost-effective than standard of care alone, and five studies reported that dapagliflozin plus standard care was dominant over standard care alone—meaning it was associated with both lower costs and better outcomes in those analyses. Cost-effectiveness was reported across diverse CKD populations, including CKD with and without diabetes, diabetic kidney disease, and non-diabetic CKD.

The authors caution that the economic value of dapagliflozin was not uniform. It varied according to patient characteristics, the willingness-to-pay threshold applied in each analysis, and the economic perspective adopted, such as whose costs are counted. Drug costs, dialysis costs, and CKD efficacy were identified as important drivers of variation in the incremental cost-effectiveness ratio or incremental cost-utility ratio reported by the studies.

The review’s conclusion is deliberately measured: available evidence suggests that dapagliflozin combined with standard of care may be cost-effective or dominant compared with standard care alone across diverse CKD populations, but its economic value varies with willingness-to-pay thresholds, patient populations and economic perspectives. Because this is a systematic review of model-based economic evaluations rather than new clinical trial data, the findings reflect the assumptions and settings of the included studies, and the authors note the evidence base remains sensitive to context. The article is open access, and the published version was shared early as a peer-reviewed, accepted manuscript carrying a permanent DOI, subject to further edits before the final Version of Record.

Subject of Research: Cost-effectiveness of dapagliflozin for chronic kidney disease

Article Title: Cost-effectiveness of dapagliflozin for the treatment of chronic kidney disease: a systematic review

Article References: Jiang, Z., Yan, N., Chen, D., Xiao, C., Le, F., & Zhang, J. (2026). Cost-effectiveness of dapagliflozin for the treatment of chronic kidney disease: a systematic review. Cost Effectiveness and Resource Allocation. https://doi.org/10.1186/s12962-026-00817-x

Image Credits: AI Generated

DOI: 10.1186/s12962-026-00817-x

Keywords: dapagliflozin, chronic kidney disease, cost-effectiveness, systematic review, health economics, ICER, diabetic kidney disease, health technology assessment, willingness-to-pay threshold, standard of care, treatment, chronic