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Pharmacoecon Open. 2018 Dec;2(4):459-467. doi: 10.1007/s41669-017-0062-z.

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

PharmacoEconomics - open

Claudio Jommi, Patrizio Armeni, Margherita Battista, Paolo di Procolo, Giuseppe Conte, Claudio Ronco, Mario Cozzolino, Anna Maria Costanzo, Umberto di Luzio Paparatti, Gabriella Concas, Giuseppe Remuzzi,

Affiliations

  1. Department of Pharmaceutical Sciences, Università del Piemonte Orientale, Largo Donegani 2, Novara, Italy. [email protected].
  2. Centre for Research in Health and Social Care Management (CERGAS), SDA School of Management Bocconi, Via Roentgen 1, Milan, Italy. [email protected].
  3. Centre for Research in Health and Social Care Management (CERGAS), SDA School of Management Bocconi, Via Roentgen 1, Milan, Italy.
  4. Department of Pharmaceutical Sciences, Università del Piemonte Orientale, Largo Donegani 2, Novara, Italy.
  5. Nephrology Division, School of Medicine, Second University of Naples, Via Santa Maria di Costantinopoli, 104, Naples, Italy.
  6. Department of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Viale Ferdinando Rodolfi, 37, Vicenza, Italy.
  7. Renal Division, Department of Health Sciences, ASST Santi Paolo e Carlo, University of Milan, Via A. Di Rudinì, 8, Milan, Italy.
  8. Abbvie Srl, Campoverde di Aprilia, Via Pontina, 52, Aprilia, Latina, Italy.
  9. Struttura Complessa Territoriale Nefrologia e Dialisi-ASL 8 Cagliari, Via Is Mirrionis, 92, Cagliari, Italy.
  10. IRCCS, Istituto di Ricerche Farmacologiche Mario Negri, Via GB Camozzi 3, Ranica, Bergamo, Italy.

PMID: 29623638 PMCID: PMC6249198 DOI: 10.1007/s41669-017-0062-z

Abstract

BACKGROUND: Chronic 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.

OBJECTIVE: The 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.

METHODS: A 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.

RESULTS: The 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.

CONCLUSION: Despite 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.

References

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