OBJECTIVES: To estimate the economic burden of CKD-T2D in Central America 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-ESRD and death). For this model, a cohort of 1.000, 40-year-old people with T2D was used, and a time horizon up to 75 years old (according to weighted life expectancy in Central America)

RESULTS: Using an exchange rate according with each country[1], the estimated direct annual cost per patient was $2.537,10 USD for microalbuminuria, $2.389,10 USD for macroalbuminuria and $29.454,70 USD for ESRD. Healthcare system costs for microalbuminuria were $2.394,70 USD, macroalbuminuria were $2.258,30 USD and $25.623,30 USD for ESRD. Out-of-pocket expenses were $142,40 USD, $130,80 USD, and $3.831,40 USD for microalbuminuria, macroalbuminuria and ESRD, respectively. Indirect costs per person were found to be $647,76 USD for micro- and macroalbuminuria, $3.556,46 USD for ESRD and $6.228,48 USD, with a total of 14,49 DALY

CONCLUSIONS: The economic burden of the CKD-T2D disease for the group of Central American countries is around $216.335 thousands of dollars for a cohort of 1.000 people

[1] Exchange rates used: (1) Costa Rica: $662 Costa Rican colones per-US dollar (USD); (2) Panamá: $1 Panamanian balboa per US dollar (USD); (3) Guatemala: $7,94 Guatemalan quetzales per US dollar (USD); (4) El Salvador: $1 Salvadoran colón per US dollar (USD); (5) Dominican Republic: $59,84 Dominican pesos per US dollar (USD); (6) Nicaragua: $38,52 Nicaraguan córdobas per US dollar (USD); (7) Honduras: $25,16 Honduran lempiras per US dollar (USD).