METHODS: Hyperkalemia economic burden was determined by “cost of Illness methodology”. After calculating direct and indirect costs, weight in frequency, and determining the annual costs per patient, the total cost is reached on the basis of the indicated prevalence. An expert panel has been organized for the use of health resources. Direct costs were calculated annually from a reimbursement agency perspective, taking into account the resource usage, frequency, and usage rates. Indirect costs that belong to patients such as productivity loss were also calculated. Patients' absenteeism due to illness, sickness reports, and absenteeism due to treatment as well as transportation costs and out-of-pocket payments were also calculated under indirect costs. Premature death cost was included as an effective parameter.

RESULTS: The estimated prevalence of moderate and severe hyperkalemia was 0,035% in the overall population. The annually direct and indirect medical cost of treatment of moderate and severe hyperkalemia per patient was $944.5. The annually indirect cost of moderate-severe hyperkalemia per patient was $1876.4 and the total cost was $2820.9. Considering the total patient number of moderate-severe hyperkalemia as 22,822; the total direct cost was determined as $21,555,893.9 from the payer perspective. According to the literature, premature death is a major problem for patients. When hyperkalemia patients were compared to normokalemia patients, premature death risk was %0,2 times higher for diabetes mellitus patients with hyperkalemia and %0,3 times higher for chronic kidney disease and heart failure patients with hyperkalemia. For an indirect cost, not only premature death but also productivity loss is calculated as $42,822,920.78 resulting in total moderate-severe hyperkalemia cost for Turkey to be $ 64,379,022.50 including direct costs.

CONCLUSIONS: The economic burden of hyperkalemia is very high for Turkey despite the low prevalence.