Cost of Type 2 Diabetes Patients with Chronic Kidney Disease Based on Real-World Data: An Observational Population-Based Study in Spain

Abstract

This study analyzed the prevalence, costs and economic impact of chronic kidney disease CKD in patients with T2D in a Spanish Health District using real-world data. Observational cross-sectional study in adult patients with T2D was through data extracted from the information systems of the Valencia Clínico–La Malvarrosa Health District in the year 2015. Patients were stratified with the KDIGO classification for CKD. Additionally, patients were assigned to Clinical Risk Groups (CRGs) according to multimorbidity. Direct costs of primary and specialized care, and medication were estimated. The prevalence of T2D in the database population (n = 28,345) was 10.8% (mean age (SD) = 67.8 years (13.9); 51.5% male). Up to 14.935 patients (52.6%) had data on kidney function. According to the KDIGO classification, 66.2% of the patients were at low risk of CKD, 20.6% at moderately increased risk, 7.9% at high risk, and 5.2% at very high risk. The average healthcare costs associated with these four risk groups were EUR 3437, EUR 4936, EUR 5899 and EUR 7389, respectively. The large number of T2D patients with CKD in the early stages of the disease generated a significant increase in direct healthcare costs. The economic impact could be mitigated by early and comprehensive therapeutic approaches.

Prevalence and predictors of chronic kidney disease among type 2 diabetic patients worldwide, systematic review and meta-analysis

“…In this systematic review and meta-analysis 20 studies were done in 13 different countries globally. Two studies done in Ethiopia [43,44],one study each in Ghana [45], United Arab Emirates [46], Australia [47], Germen [48], united kingdom, Malaysia, Palestine [49][50][51], three studies in USA [52][53][54] ,two in China [55,56],two in Spain [57,58], three in Thailand [59][60][61], and in six countries in Europe and Asia [62].in this study most of the studies were hospital based except two are community level. The total sample size was 1,711,926 with maximum sample 1, 177 896 sample in six European and Asian countries [62] and minimum of 119 sample size in Ethiopia [44] (Table 1).…”

The Place and Value of Sodium-Glucose Cotransporter 2 Inhibitors in the Evolving Treatment Paradigm for Type 2 Diabetes Mellitus: A Narrative Review

“…A recent study examining the cost of CKD in T2DM showed that, although the cost per person was especially high in those with advanced stages of CKD, direct healthcare expenditure was greatest during the initial phases of kidney disease due to the large number of individuals with T2DM in this group [ 77 ]. The study authors concluded that the economic impact of CKD in T2DM could be alleviated by timely and comprehensive approaches to management [ 77 ].…”

“…A recent study examining the cost of CKD in T2DM showed that, although the cost per person was especially high in those with advanced stages of CKD, direct healthcare expenditure was greatest during the initial phases of kidney disease due to the large number of individuals with T2DM in this group [ 77 ]. The study authors concluded that the economic impact of CKD in T2DM could be alleviated by timely and comprehensive approaches to management [ 77 ]. Some clinicians have stated the case for earlier use of SGLT2is and other newer glucose-lowering therapies in the T2DM treatment pathway, with the aim of delaying or avoiding CV or renal complications, reducing associated costs and improving long-term QoL for people with T2DM [ 78 , 79 ].…”