PROMOD Study: Forecasting the Dialysis Burden in Morocco and the Cost-Avoidance Potential of Optimal Nephroprotection: A Markov-Based Economic Model
Author(s)
omar maoujoud, PhD, MD1, Amal Yassine, PhD, MD2.
1President, Societe Marocaine de l'economie de produits de santé, Marrakech, Morocco, 2Moroccan Society for Health Products Economy & ISPOR MAGHREB CHAPTER, Mohammedia, Morocco.
1President, Societe Marocaine de l'economie de produits de santé, Marrakech, Morocco, 2Moroccan Society for Health Products Economy & ISPOR MAGHREB CHAPTER, Mohammedia, Morocco.
OBJECTIVES: To project the burden of dialysis in Morocco by 2035 using a Markov model, and to estimate the potential cost avoidance and return on investment (ROI) of a national nephroprotection strategy aimed at slowing CKD progression.
METHODS: A cohort-based Markov model with three health states CKD not on dialysis, dialysis, and death, was developed to simulate the evolution of a representative Moroccan CKD population from 2025 to 2035. Transition probabilities were calibrated using demographic data and published epidemiology. Two scenarios were modeled: a status quo scenario based on current trends and care patterns, and an intervention scenario assuming wide deployment of an optimal nephroprotection strategy, modeled as a 30% relative risk reduction (RRR) in the transition from CKD to dialysis. The annual cost per dialysis patient was estimated from official Moroccan AMO tariffs. The model outputs included projected dialysis prevalence, number of dialysis patients avoided, cumulative cost avoidance, and ROI. Sensitivity analyses were performed by varying the RRR and dialysis cost parameters.
RESULTS: In the absence of intervention, the dialysis population in Morocco is projected to grow from 42,000 in 2025 to 88,000 in 2035. The introduction of a nationwide nephroprotection strategy could prevent dialysis in over 16,500 patients across the 10-year horizon. This would translate into over 19 billion MAD in avoided direct healthcare expenditures. The estimated ROI is 2.67, meaning every 1 MAD invested in nephroprotection could generate 2.67 MAD in savings from reduced dialysis burden. The model’s findings remained robust across sensitivity scenarios.
CONCLUSIONS: The PROMOD model highlights a critical inflection point for Morocco’s renal health policy. Without intervention, dialysis prevalence could more than double by 2035, threatening sustainability. Scaling up nephroprotective interventions offers a strategic opportunity to both improve patient outcomes and contain costs. These findings support the urgent integration of renal prevention into national chronic disease policies.
METHODS: A cohort-based Markov model with three health states CKD not on dialysis, dialysis, and death, was developed to simulate the evolution of a representative Moroccan CKD population from 2025 to 2035. Transition probabilities were calibrated using demographic data and published epidemiology. Two scenarios were modeled: a status quo scenario based on current trends and care patterns, and an intervention scenario assuming wide deployment of an optimal nephroprotection strategy, modeled as a 30% relative risk reduction (RRR) in the transition from CKD to dialysis. The annual cost per dialysis patient was estimated from official Moroccan AMO tariffs. The model outputs included projected dialysis prevalence, number of dialysis patients avoided, cumulative cost avoidance, and ROI. Sensitivity analyses were performed by varying the RRR and dialysis cost parameters.
RESULTS: In the absence of intervention, the dialysis population in Morocco is projected to grow from 42,000 in 2025 to 88,000 in 2035. The introduction of a nationwide nephroprotection strategy could prevent dialysis in over 16,500 patients across the 10-year horizon. This would translate into over 19 billion MAD in avoided direct healthcare expenditures. The estimated ROI is 2.67, meaning every 1 MAD invested in nephroprotection could generate 2.67 MAD in savings from reduced dialysis burden. The model’s findings remained robust across sensitivity scenarios.
CONCLUSIONS: The PROMOD model highlights a critical inflection point for Morocco’s renal health policy. Without intervention, dialysis prevalence could more than double by 2035, threatening sustainability. Scaling up nephroprotective interventions offers a strategic opportunity to both improve patient outcomes and contain costs. These findings support the urgent integration of renal prevention into national chronic disease policies.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE621
Topic
Economic Evaluation, Epidemiology & Public Health, Methodological & Statistical Research
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Thresholds & Opportunity Cost
Disease
Diabetes/Endocrine/Metabolic Disorders (including obesity), Rare & Orphan Diseases, Urinary/Kidney Disorders