Presentation (CTI)

OBJECTIVES: Chronic kidney disease (CKD) is a resource-intensive complication of type 2 diabetes, involving long-term monitoring, pharmacological treatment, dialysis-related supplies, adverse event management, and hospital-based care. This study aimed to estimate the annual per-patient direct medical costs attributable to CKD among patients with type 2 diabetes in Türkiye and to identify the main cost drivers from the public payer perspective.
METHODS: A retrospective, micro-costing analysis was performed from the Turkish public payer perspective to estimate annual per-patient direct medical costs attributable to CKD in patients with type 2 diabetes. CKD-related resource use across primary, secondary, and tertiary care was defined through expert-informed cost categories, as no prospective national database routinely captures these data. Resource use estimates were obtained from 15 Turkish clinical experts and combined with unit costs from the Healthcare Implementation Communiqué (SUT). Cost components included diagnostic tests, scheduled outpatient and inpatient care, pharmacological treatment, medical consumables and devices, monitoring, adverse events, complications, and inpatient procedures. Total costs were calculated by applying unit costs to resource use inputs and aggregating all components, with external review by a clinician advisory board.
RESULTS: The estimated annual per-patient direct medical cost attributable to CKD was TRY 155,748 (US$3,351, based on the exchange rate applied in the analysis). Costs were largely driven by medical consumables and devices, which represented the largest cost component (TRY 94,269; 60.5%). Other key contributors were pharmacological treatments (TRY 22,836; 14.7%), complications (TRY 15,106; 9.7%), inpatient procedures (TRY 10,808; 6.9%), and treatment-related adverse events (TRY 8,539; 5.5%).
CONCLUSIONS: CKD imposes a substantial annual direct medical cost burden on the Turkish public healthcare system, mainly driven by dialysis-related consumables and/or devices, pharmacological treatment, and complication management.