Objectives: To investigate the budgetary impact from the introduction of empagliflozin as add-on treatment to Standard of Care (SoC) for adults with Chronic Kidney Disease (CKD) in Greece.

Methods: A budget impact model was adapted, from a public payer perspective, to delineate the financial implications of introducing empagliflozin for the treatment of CKD in Greece, over the next five years (2025–2029). Epidemiological data were retrieved from literature and local experts estimates on CKD patients. Two market scenarios were considered and compared, the current market where empagliflozin was not included in the indication for CKD in Greece, and the projected market scenario, examined the reimbursement and increased penetration of empagliflozin+SoC in the existing market. Following a public payer perspective, only direct medical costs related to drug acquisition, disease management and adverse events costs, were considered in the analysis (€,2023). The measured outcomes were incremental cost and total budget impact, calculated by subtracting the current scenario from the new drug scenario, for all CKD patients.

Results: The total number of the eligible population was 409,013 patients per year and the number of patients treated with empagliflozin+SoC in the new market scenario was estimated to increase from 4,090 in 2025 to 26,586 patients in 2029. Moreover, CKD evolves faster in SoC arm, so patients move to worse levels of the disease faster than with dapagliflozin and empagliflozin, so present higher costs. Overall, the budget impact analysis suggests that the reimbursement of empagliflozin+ SoC for the indication of CKD would be a cost-saving option (-€17,620,805) for the public payer, over a five-year time horizon.

Conclusions: This budget impact analysis suggests that introducing empagliflozin for CKD treatment in Greece yields significant clinical benefits with manageable budget impacts in the initial two years. Overall, reimbursement appears cost-saving for the public payer over five-years.