OBJECTIVES: Updated cost-effective models are needed to assess the value of current CKD interventions in the UK. A key objective was to assess if population-level interventions including 1) early/improved diagnosis, 2) improved CKD management, 3) use of SGLT-2 inhibitors, and 4) increased rates of transplantation, could be cost-saving or cost-effective.

METHODS: A population-level Markov model was used to estimate the current and future incidence/prevalence and economic burden of CKD across all stages and show the directional impact of the four interventions based on costs and outcomes. The model was developed to capture both NHS (direct cost) and UK economy (wider economic cost) perspectives while capturing the progression between undiagnosed and diagnosed people with CKD. The schematic was modified to include additional health states for transplantation (acute event), post-transplant, cardiovascular disease (acute event) and post-CVD. Based on the availability and quality of data, stages 1 and 2 within the model were disaggregated, and stages 3a and 3b were combined. Each cycle length was defined as quarterly (every 3 months) and the time horizon for the model was set to 10 years.

RESULTS: All interventions, individually or combined, showed a cost-effective or cost-saving Incremental Cost-Effectiveness Ratio (ICER). When combined, interventions prevented more than 10,000 deaths over the 10-year time horizon, with 49,574 quality-adjusted life years saved. This is predicted to cost £7,688 per quality-adjusted life years. The reduction in indirect costs (travel and lost economic productivity) of £445.7 million would more than offset the total increase in NHS costs of £381.1 million.

CONCLUSIONS: Economic modelling suggests that improved implementation of four illustrative healthcare interventions could save more than 10,000 lives by 2033. These interventions individually and collectively are shown to be cost-effective or cost-saving, where costs to the NHS are offset by quality adjusted life years gained.