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Kidney Week

Abstract: SA-PO1114

Age-Stratified Cost of Care in CKD: Real-World Data from a Retrospective Cohort Study

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Chatterjee, Satabdi, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
  • Levy, Adrian R., Dalhousie University, Halifax, Nova Scotia, Canada
  • Stackland, Sydnie, Panalgo LLC, Boston, Massachusetts, United States
  • Bengtson, Lindsay, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
  • Donato, Bonnie M.k., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
Background

Chronic kidney disease (CKD) affects an estimated 14% of US adults, and is more common in those aged 65 years or older, than younger age groups. Little is known regarding the costs of CKD by age. In a large cohort of patients with prevalent CKD, this study described the mean total and direct medical costs accrued in the overall and age-stratified cohorts.

Methods

A retrospective longitudinal cohort study was conducted using Optum® Market Clarity electronic health record-linked claims data. The study cohort included adults with 2 estimated glomerular filtration rates <60 ml/min/1.73m2 (3-12 months apart) followed by an ICD 9/10 code for CKD, and 1-year of continuous enrolment pre- and post-CKD diagnosis. These included patients diagnosed before January 1, 2020 plus new cases arising in 2020 (prevalent cohort); subjects who died or disenrolled in 2020 were excluded upon censoring. Total costs including direct medical costs (inpatient, outpatient, emergency department) as well as medications were calculated for the prevalent CKD cohort for the year 2020. Mean costs per patient were computed for the overall cohort and by age groups.

Results

In 2020, there were 214,631 patients with CKD, consisting of: 7,270 (3.4%) aged 18-49 y; 44,879 (20.9%) aged 50-64 y; 115,070 (53.6%) aged 65-80 y; and 47,412 (22.1%) aged >81 y. The mean (SD) total and medical costs were $68,095 (139,099) and $48,379 (104,185), respectively. Cost breakdown by age groups showed annual mean total costs of: $82,958 (203,481), $76,073 (170,039), $69,675 (135,308), and $54,432 (95,669), among the 18-49, 50-64, 65-80, and >81 y subgroups, respectively. Total medical costs were $53,388 (139,247), $50,826 (126,435), $49,614 (101,644), and $42,297 (76,868), respectively, ranging from 64% in those aged 18-49 to 78% among those >81 y.

Conclusion

In a large cohort of insured patients with prevalent CKD, medical costs accounted for nearly two-thirds of the total costs, and this proportion increased in older age groups. Better understanding of the drivers of medical costs by age along with other sociodemographic and clinical characteristics can provide critical insights on surveillance of CKD, and consequently, informing optimal strategies for reducing the burden of CKD.

Funding

  • Commercial Support – Boehringer Ingelheim