OBJECTIVES: To estimate the economic burden of CKD-T2D in Ecuador when the standard of care is used

METHODS: A social perspective was used, considering direct costs related to healthcare system and to households; and indirect costs, using Disability Adjusted Life Years (DALY) and a reference of average income per worker. Costs were estimated using a micro-costing method. We developed a Markov´s model with five stages of the disease (Normoalbuminuria, Microalbuminuria, Macroalbuminuria, End-stage renal disease and death). For this model, a cohort of 1.000, 40-year-old people with T2D was used, and a time horizon up to 77 years old (according to life expectancy in Ecuador)

RESULTS: The estimated direct annual cost per patient was $2.202,00 USD for microalbuminuria, $2.376,70 USD for macroalbuminuria and $24.959,80 USD for ESRD. Healthcare system costs for microalbuminuria were $874,60 USD, macroalbuminuria were $1.071,40 USD and $15.784 USD for ESRD. Out-of-pocket expenses were $1.327,40 USD, $1.305,30 USD, and $9.175,80 USD for microalbuminuria, macroalbuminuria and ESRD, respectively. Indirect costs per person were found to be $909,31 USD for micro- and macroalbuminuria, $4.992,48 USD for ESRD and $8.743,40 USD for death stage, with a total of 15,16 DALY

CONCLUSIONS: The economic burden of the CKD-T2D disease for the group of Ecuador is around $104.239 thousands of dollars for a cohort of 1.000 people