Abstract: SA-PO1124
A Contemporary Economic Model of CKD in the United States
Session Information
- CKD: Patient-Oriented Care and Case Reports
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Briggs, Andrew, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Kohli-Lynch, Ciaran, Northwestern University, Evanston, Illinois, United States
- Chatterjee, Satabdi, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
- Donato, Bonnie M.k., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
- Levy, Adrian R., Dalhousie University, Halifax, Nova Scotia, Canada
- Kovesdy, Csaba P., The University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, United States
Background
Chronic kidney disease (CKD) impacts an estimated 14% of US adults, and is associated with reduced quality of life, progression to kidney failure, and cardiovascular disease (CVD), resulting in high healthcare costs. The recently updated Kidney Disease: Improving Global Outcomes (KDIGO) guidelines have highlighted the importance of CVD management to improve CKD outcomes and including a role for sodium-glucose cotransporter-2 (SGLT2) inhibitors in delaying disease progression and improving CVD outcomes.
Methods
A state transition model was developed (see figure) to follow a hypothetical cohort of US adults with CKD over their lifetime. Progression of CKD was tracked through KDIGO health states defined by estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (uACR). Individuals with CKD could transition to kidney failure, major adverse cardiovascular event (myocardial infarction or stroke), heart failure, or death from other causes. Probability of a first event was determined by eGFR, uACR, and diabetes status, with age and sex determining the background mortality risks. Individuals who had a non-fatal first event were followed until death. Resource utilization, costs, transition probabilities, and utilities were derived from peer-reviewed studies.
Results
The model predicted clinical events associated with current management as well as healthcare costs and quality adjusted life years (QALY). Under usual care, the model estimated lifetime outcomes of 6.8 QALYs and $150,386, with time prior to a clinical event contributing most to the QALYs, and dialysis contributing most to the healthcare costs. KDIGO guidelines for optimizing CVD treatment and SGLT2 inhibitor treatment were shown to be cost-effective (cost-per-QALY<$100,000).
Conclusion
The current model can predict clinical events and consequent impacts on healthcare costs and QALYs. This enables estimation of the value of various guideline-recommended strategies designed to treat patients at all stages of CKD.
Funding
- Commercial Support – Boehringer Ingelheim