Inside CKD: Projecting the Population Level Economic Burden of Chronic Kidney Disease According to Urine Albumin-to-Creatinine Ratio (uACR) Categories

Speaker(s)

Garcia Sanchez JJ1, De Nicola L2, Correa-Rotter R3, Navarro-González JF4, Power A5, Nowicki M6, Wittmann I7, Cabrera CS8, Barone S9, Coker T10, Retat L10
1Health Economic and Payer Evidence, AstraZeneca, Cambridge, Camebridgeshire, UK, 2Division of Nephrology, Department of Advanced Medical and Surgical Sciences, Nephrology Unit - University of Campania “Luigi Vanvitelli”, Vanvitelli, Napoli, Italy, 3Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, EM, Mexico, 4University Hospital Nuestra Senora de Candelaria, Santa Cruz, Tenerife, Spain, 5North Bristol NHS Trust, Bristol, Somerset, UK, 6Medical University of Lodz, Lodz, Lodzkie, Poland, 7University of Pécs, Pécs, Hungary, 8AstraZeneca, Gothenburg, ON, Sweden, 9Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA, 10HealthLumen, London, UK

Presentation Documents

OBJECTIVES: Chronic kidney disease (CKD) costs increase with disease severity, particularly when patients receive kidney replacement therapy. Kidney Disease: Improving Global Outcomes (KDIGO) highlighted uACR as an important prognostic factor alongside estimated glomerular filtration rate (eGFR). This analysis aims to project the current, annual economic burden of CKD for national populations by uACR categories (normo-albuminuria [A1], micro-albuminuria [A2] and macro-albuminuria [A3]).

METHODS: Across 31 countries/regions, the Inside CKD microsimulation generated 640 million virtual individuals who were assigned baseline characteristics including age, diagnosis status based on CKD stage (eGFR and uACR), cardiovascular complication rates and mortality based on data from published national health/epidemiological surveys. Country-specific direct costs were applied annually based on diagnosed CKD stage and incidence of cardiovascular complications. The model projected population size, incidence of complications and associated prevalent costs according to uACR category for the year 2023.

RESULTS: Across all settings in 2023, there was a higher mean estimated prevalence of patients with normo- or micro-albuminuria (41.0% and 49.7%, respectively) versus macro-albuminuria (9.3%). Projected cumulative costs associated with diagnosed CKD management were a mean $6.7 billion across countries/regions and showed considerable variance (median: $1.4 billion; min: $0.07 billion [Poland]; max: $93.6 billion [USA]). A mean 86.5% of costs were attributed to patients with normo-albuminuria versus 11.3% and 2.2% for micro- and macro-albuminuria, respectively. Globally, patients with normo- or micro-albuminuria were expected to contribute 92.6% of the total mean burden associated with cardiovascular complications (heart failure $11.8 billion; myocardial infarction: $16.6 billion; stroke: $10.0 billion).

CONCLUSIONS: Our study estimates the economic burden of CKD to arise primarily from patients with lower uACR at the population level. Our analysis supports policy interventions in individuals with normo- or micro-albuminuria; by screening patients earlier, this larger population could receive improved care to delay disease progression and alleviate pressure on healthcare systems.

Code

EE724

Topic

Economic Evaluation, Methodological & Statistical Research, Study Approaches

Topic Subcategory

Decision Modeling & Simulation

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Urinary/Kidney Disorders