Abstract: FR-PO1027
Out-of-Pocket Expenditures for Patients with CKD in the Medical Expenditure Panel Survey (MEPS)
Session Information
- Social, Environmental, and Economic Determinants of Kidney Health
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Das, Abhishek Kumar, Johns Hopkins University, Baltimore, Maryland, United States
- Tummalapalli, Sri Lekha, Weill Cornell Medicine, New York, New York, United States
Background
Chronic kidney disease (CKD) affects 37 million Americans and nearly half of patients with CKD report experiencing financial hardship from medical bills. Out-of-pocket healthcare costs are a key source of financial strain. An analysis of 2002-2011 data from the Medical Expenditure Panel Survey (MEPS) found that average out-of-pocket costs declined from $1,707/yr to $1,218/yr during the study period. Prescription drugs accounted for $730/yr in costs in 2010/2011. Recent novel therapeutics such as SGLT2 inhibitors may contribute to excess out-of-pocket costs and more contemporary estimates are needed.
Methods
We used data from the Medical Expenditure Panel Survey (MEPS), which is a nationally representative set of extensive surveys of individuals, their medical providers, and employers across the United States. We used the full-year household component consolidated data files from 2018 to 2021 and restricted to individuals with ICD-10 codes for CKD (N18). We examined mean out-of-pocket costs per year for inpatient hospital stays, emergency department visits, hospital outpatient visits, office-based visits, and prescription medicines. Sample weights were applied to account for the complex survey design.
Results
Among the 115,114 people surveyed by MEPS from 2018-2021, we restricted to 291 observations from 141 patients with diagnosis codes for CKD. Average out-of-pocket costs were $234.53/yr for inpatient costs, $135.89/yr for emergency department visits, $143.04/yr for hospital outpatient visits, $833.93/yr for office-based visits, and $783.77/yr for prescription medicine costs.
Conclusion
Patients with CKD experienced higher out-of-pocket costs in 2018-2021 compared with prior estimates. Prescription medicine costs accounted for a higher share of out-of-pocket expenditures, which may be attributable to novel therapeutics for CKD. Health policy levers such as the Medicare Part D out-of-pocket spending caps in the Inflation Reduction Act may lessen the financial burden of CKD and its complications.