Use of Clinical-trials and Simulation Models to Estimate Cost-effectiveness of Non-steroidal Mineralocorticoid Antagonists, RASi and SGLT2i as Triple Therapy With Type 2 Diabetes and Chronic Kidney Disease

This study uses computer models and existing trial data to figure out whether adding a newer class of blood pressure/kidney-protecting medication (called a non-steroidal mineralocorticoid antagonist, or nsMRA) to an existing two-drug regimen is cost-effective for people who have both type 2 diabetes and chronic kidney disease. **You may be eligible if...** - You are 18 or older with type 2 diabetes for at least 6 months - You have chronic kidney disease with reduced kidney function or significant protein in your urine - You are already taking an SGLT2 inhibitor (like dapagliflozin or empagliflozin) and a blood pressure medication (ACE inhibitor or ARB) at stable doses - Your potassium level is below 4.8 mmol/L **You may NOT be eligible if...** - You have type 1 diabetes - You are allergic or intolerant to any of the study medications - You are pregnant or planning to become pregnant - Your blood sugar control is very poor (HbA1c above 9%) or blood pressure is severely uncontrolled - You've had a stroke, worsening heart failure, heart attack, or diabetic emergency in the past 6 months - You are on dialysis or likely to need a kidney transplant soon Talk to your doctor to see if this trial is right for you.