Healthcare costs of the progression of chronic kidney disease and different dialysis techniques estimated through administrative database analysis

Roggeri, Alessandro; Roggeri, Daniela Paola; Zocchetti, Carlo; Bersani, Maurizio; Conte, Ferruccio; Rene, .

doi:10.1007/s40620-016-0291-8

Cited by 39 publications

(39 citation statements)

References 25 publications

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“…Despite the different approach, we found some commonalties with other studies, i.e. mean annual costs well below dialysis costs [5, 10, 11] and an important increase in costs for more severe disease stages [5]. …”

Section: Discussionmentioning

confidence: 66%

“…The long follow-up period (3 years) and the involvement of healthcare centres in different regions allowed our analysis to produce a reasonable estimate of the actual unit cost in Italy, despite not stating that recruited patients represented all Italian patients with CKD before dialysis as no epidemiological data on CKD were available (incidence, prevalence, distribution of its various stages, etc.). However, the multicentric nature of the study and the fact that most regions were included, and recruited centres were selected on the grounds of a minimum number of patients who visited the centre, make this study more representative of the population than other studies focussed on a single region [10, 11]. …”

Section: Discussionmentioning

confidence: 99%

“…The first study, in the Piedmont region (7.2% of the Italian population), compared incident-to-dialysis patients observed for the 12 months before dialysis entrance (€11,123) and established dialysis patients (€53,764) [10]. The second analysis was carried out in the Lombardy Region (16.5% of the Italian population) and found a unit healthcare cost per patient of €5239, €12,303 and €38,821 in the 12- to 24-month period before dialysis, 0–12-month period before dialysis, and the first year of dialysis, respectively [11]. …”

Section: Introductionmentioning

confidence: 99%

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The Cost of Patients with Chronic Kidney Failure Before Dialysis: Results from the IRIDE Observational Study

Jommi

Armeni

Battista

et al. 2017

PharmacoEconomics Open

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BackgroundChronic kidney disease (CKD) is an important public health problem. Most of the evidence on its costs relates to patients receiving dialysis or kidney transplants, which shows that, in these phases, CKD poses a high burden to payers. Less evidence is available on the costs of the predialytic phase.ObjectiveThe aim of this study was to estimate the annual cost of patients with CKD not receiving dialysis treatment, using the Italian healthcare system perspective and a prospective approach.MethodsA 3-year observational study (December 2010–September 2014) was carried out to collect data on resource consumption for 864 patients with CKD. Costs were estimated for both patients who completed the follow-up and dropouts.ResultsThe mean annual total (healthcare) cost per patient equalled €2723 (95% confidence interval 2463.0–2983.3). Disease severity (higher CKD stage), multiple comorbidities, dropout status and belonging to the southern region are predictive of higher costs. Pharmaceuticals, hospitalisation, and outpatient services account for 71.5, 18.8 and 9.7% of total healthcare expenditure, respectively. Recent estimates of Italian costs of patients receiving dialysis are nine times the unit costs of CKD for patients estimated in this study. Unit costs at stage 5 CKD (the highest level of severity) equals 4.7 times the costs for patients at stage 1 CKD.ConclusionDespite its limitations, this study provides further evidence on the opportunity to invest in the first phases of CKD to avoid progression and an increase in healthcare costs.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Cost of Patients with Chronic Kidney Failure Before Dialysis: Results from the IRIDE Observational Study

Jommi

Armeni

Battista

et al. 2017

PharmacoEconomics Open

View full text Add to dashboard Cite

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“…This may be part of a general improvement strategy aimed to maximize quality of life, patient-reported outcomes, and cost-savings [29, 30]. …”

Section: Discussionmentioning

confidence: 99%

Survival and time-to-transplantation of peritoneal dialysis versus hemodialysis for end-stage renal disease patients: competing-risks regression model in a single Italian center experience

et al. 2016

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AimsDespite several studies reporting similar outcomes for peritoneal dialysis (PD) and hemodialysis (HD), the former is underused worldwide, with a PD prevalence of 15% in Italy. In 2008, the Unit of Nephrology and Dialysis of the Healthcare Trust of the Autonomous Province of Trento implemented a successful PD program which has increased the proportion of PD incident patients from 7 to 47%. We aimed to assess the effect of this extensive use of PD by comparing HD and PD in terms of survival and time-to-transplantation.MethodsA total of 334 HD and 153 PD incident patients were enrolled between January 2008 and December 2014. After screening for exclusion criteria and propensity score matching, 279 HD and 132 PD patients were analyzed. Survival and time-to-transplantation were assessed by competing-risks regression models, using death and transplantation as primary and competing events.ResultsCrude and adjusted regression models for survival revealed the absence of significant differences between HD and PD cumulative incidence functions (subhazard ratio: 1.09, p = 0.62 and 1.34, p = 0.10, respectively). Differently, crude and adjusted regression models for transplantation revealed a lower time-to-transplantation for PD versus HD patients (subhazard ratio: 2.34, p < 0.01, and 2.57, p < 0.01, respectively). The waiting time for placement in the transplant waiting list was longer in HD than PD patients (330 vs. 224 days, p < 0.01).ConclusionsThe extensive use of PD did not lead to any statistically significant difference in mortality. Furthermore, PD was associated with lower time to transplantation. PD may be a viable option for large-scale dialytic treatment in the advanced chronic kidney disease population.

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“…The majority of CKD patients is classified as stage 3 [4]. A few international studies have compared the cost of end-stage renal disease (CKD stage 5) to that of earlier stages at an individual or population level [5,6,7,8,9]. These studies have consistently shown an increase in CKD cost with progression of disease.…”

Section: Introductionmentioning

confidence: 99%

Costs of patients with chronic kidney disease in Germany

et al. 2020

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Background This study aimed to determine the costs and distribution of healthcare spending of patients with chronic kidney disease (CKD) at stages 3 and 4 and on dialysis both at the individual and population level in Germany. Methods The study took the perspective of the German statutory health insurance (SHI) system and analyzed claims data on 3,687,015 insurees from the year 2014. To extrapolate costs to the whole SHI population, a literature search on the prevalence of CKD was conducted. Results Average costs per person per year in an age-and gender-matched control group of the normal population were €2,876 (95% confidence interval [CI], €2,798 to €2,955) and �2.8-fold higher in CKD patients (€8,030 [95% CI, €7,848 to €8,212] at CKD stage 3, €9,760 [95% CI, €9,266 to €10,255] at CKD stage 4, and €44,374 [95% CI, €43,608 to €45,139] on dialysis). At CKD stages 3 and 4 the major cost driver was hospitalizations, contributing to more than 50% of total expenditures. Among dialysis patients, hospitalizations and dialysis-treatment costs contributed to 23% and 53% of total healthcare spending, respectively. At CKD stages 3 and 4, patients with the highest 20% of healthcare spending showed a considerable increase in per-patient costs over the reference population, while the bottom 80% of patients generated only moderately higher per-patient costs (p < 0.001). Comparing total CKD costs to total SHI expenditures yields that 10.2% of SHI expenditures was driven by patients at CKD stages 3 and 4 and 1.6% by dialysis patients. Conclusions Healthcare spending of patients with CKD at stages 3 and 4 and on dialysis is concentrated among a small number of high-need patients. As hospitalizations and dialysis treatment are key drivers of total expenditures, strategies that lead to a reduction in hospitalizations, delay

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Healthcare costs of the progression of chronic kidney disease and different dialysis techniques estimated through administrative database analysis

Abstract: This study highlights a significant economic burden related to CKD and an increase in direct healthcare costs associated with the start of dialysis, pointing to the importance of prevention programs and early diagnosis.

Cited by 39 publications

References 25 publications

The Cost of Patients with Chronic Kidney Failure Before Dialysis: Results from the IRIDE Observational Study

The Cost of Patients with Chronic Kidney Failure Before Dialysis: Results from the IRIDE Observational Study

Survival and time-to-transplantation of peritoneal dialysis versus hemodialysis for end-stage renal disease patients: competing-risks regression model in a single Italian center experience

Costs of patients with chronic kidney disease in Germany

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