Investment in diabetes treatment returns almost five times more in benefits to society

1.7 million Australians have diabetes and around two-thirds also have cardiovascular disease, chronic kidney disease or both. Each year in Australia hospital admissions for cardiovascular disease and end-stage kidney disease cost over $6 billion.

SGLT2 inhibitors*, a class of medication developed for the treatment of diabetes, have been shown to reduce the risk of cardiovascular disease and kidney failure. A new report published by The George Institute, The wider benefits of SGLT2 inhibitors in Australia, has shown that making SGLT2 inhibitors widely available in Australia would save lives and reduce costs to society. 

The report found a $1 billion government investment over 10 years in SGLT2 inhibitor treatments would return almost $5 billion in benefits to society. In other words, every $1 invested returns almost $5 in benefits to society.

A government investment of $1b in SGLT2 inhibitors treatment would prevent 4284 acute kidney injuries, 8744 end stage kidney disease patients, 4148 heart attacks and 7450 deaths over 10 years.  

This report provides the first estimate of the benefits this investment could deliver to Australian society.

“Our report provides important new data to complement current evidence, supporting prioritisation of investment in SGLT2 inhibitors in Australia, so they are accessible and benefit many more Australians,” says Dr Clare Arnott, Senior Research Fellow at The George Institute and cardiologist at Royal Prince Alfred Hospital.  

Diabetes is the most common cause of chronic kidney disease and need for expensive dialysis treatment. People with diabetes and kidney disease are also at extremely high risk of kidney failure, heart attack, stroke and death.

In recent years, trailblazing research by The George Institute has shown that SGLT2 inhibitors not only reduce glucose levels in diabetes patients but also prevent cardiovascular events, such as heart failure, and slow kidney disease progression, reducing the need for dialysis.

“The evidence shows that we have a class of drug in our treatment arsenal that could potentially have a significant impact on the cardiovascular and kidney complications of type 2 diabetes. The challenge is now to get these agents to the people likely to benefit from them” says Dr Arnott.

One of the biggest barriers to this is limited knowledge among medical specialists, GPs and patient groups about the potential cost effectiveness and evidence-based benefits of SGLT2 inhibitors. Other barriers to access include a siloed and inconsistent approach to treating disease, such as prescribing medicines, and out-of-pocket expenses for SGLT2 inhibitors (outside of current Pharmaceutical Benefit Scheme (PBS) guidelines).

The George Institute encourages increased access to SGLT2 inhibitors in Australia to prevent cardiovascular disease and slow kidney disease progression in people with diabetes. This includes broadening current PBS restrictions for SGLT2 inhibitor use, and reimbursement by the government, to take into account current evidence and encouraging clinicians to prescribe these to eligible patients. 

“We have clear evidence that SGLT2 inhibitors save kidneys and save lives. It is one of few medical treatments that both improve health and save money for society. , So it’s time to make this treatment as widely available as possible, and update current PBS guidelines for the benefit of millions of Australians – it’s a no brainer,” says Professor Vlado Perkovic, Dean of Medicine, UNSW and previously Executive Director at The George Institute where he led landmark research in SGLT2 inhibitors.

“If we can get SGLT2 inhibitors to the many people with diabetes proven to benefit, and thus prevent kidney failure and heart disease, fewer patients will go on to require more invasive and costly interventions like hospitalisation, dialysis and transplantation,” says Professor Perkovic.

Around half a billion people worldwide have diabetes and up to 40% will go onto develop kidney disease. While the report findings are specific to Australia, the implications are equally relevant and important globally, particularly in low-and middle-income countries, where lack of access to costly dialysis treatment for kidney failure kills several million people each year.

The novel analysis in The wider benefits of SGLT2 inhibitors in Australia report focuses on the broad socio-economic benefit of ensuring equitable access to SGLT2s in type-2 diabetes patients in Australia. As this does not include more recently identified potential benefits specific to non-diabetic patients with heart failure and chronic kidney disease, it offers a conservative estimate of the benefits of wider access to SGLT2 inhibitors. 

*SGLT2 (sodium-glucose co-transporter-2) inhibitors are class of diabetes medication designed to lower glucose levels in type 2 diabetes patients

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Disclosure statement

• The CREDENCE and CANVAS trials were funded by Janssen, which manufactures canagliflozin, and were led by an independent, academic-led Steering Committee. George Clinical, a contract research organisation owned by George Health (the social enterprise arm of the George Institute), performed contract research services for Janssen on both trials.
• Vlado Perkovic received funding for Steering Committee roles, Advisory Board participation, and/or Scientific presentations from manufacturers of SGLT2 inhibitors, including Janssen, Astra Zeneca, Boehringer Ingelheim, Eli Lilly, Merck, Mundipharma and Mitsubishi Tanabe