OBJECTIVES To explore and uncover the cost of managing distal Renal Tubular Acidosis (dRTA) in the United Kingdom METHODS A process of face to face and telephone interviews were conducted with neprologists in leading UK centres covering England, Northern Ireland and Scotland to discuss management pathways for distal Renal Tubular Acidosis (dRTA). A number of patient cases were collected, all considered to be typical cases by managing physicians. Both adult and paediatric cases were included, however paediatric cases dominated the sample. Additionally we have sought to use the Clinical Practice Research Datalink (CPRD) database to give use additional information on resource utilisation. RESULTS Costs of managing distal Renal Tubular Acidosis (dRTA) (diagnosis and year one of treatment) ranged from £22,717 to £2,434 for 12 months of treatment. Costs did differ between adult and paediatric dTRA and genetic and acquired forms. Highest cost related to hospital admissions and percutaneous nephrolithotomy which has an NHS cost of £5,516. On average hospital, pharmacotherapy and diagnostic costs vary significantly between center and case. However for more severe cases (as described by clinician), the hospital costs related to inpatient stay contributed to 33% of total costs and interventional procedures contributed to 40% of costs. Pharmacotherapy, despite poor levels of compliance contribute to 10-40% of costs. CONCLUSIONS There is high variability in costs of managing distal Renal Tubular Acidosis (dRTA), depending on disease severity, age and treatment strategies. For some patients, interventional procedures are the main cost driver for others significant cost is related to late diagnosis.Thus, there may be a strong argument that early diagnosis and management strategies that focus on patient compliance for dRTA could lead to a decrease in potentially unnecessary resource utilisation costs and burden upon the healthcare system.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
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