OBJECTIVES: Management of CKD is costly and driven by risk factors, ageing, and other health and economic inequalities. The objective was to determine 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 economic burden of CKD across all stages and show the directional impact of four interventions based on costs and outcomes. The model was developed to capture both Payer direct costs and UK economy and productivity costs to understand the progression between undiagnosed and diagnosed people with CKD. The model included additional health states, including; transplantation, post-transplant, cardiovascular disease, and post-CVD. Each cycle length was defined as quarterly (every 3 months) and the time horizon for the model was set to 10 years. The model was set up to allow for each intervention to be assessed individually, or in combination.

RESULTS: The model estimated the combined economic impact of all four interventions would decrease the burden of CKD by £64.6 million (0.07% difference) and would increase the total Quality Adjusted Life Years (QALYs) in the population by 49,574. The clinical impact of adopting all the interventions reduced deaths by 10,495 over the 10-year period. The reduction in indirect costs (£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 provide both an economic and clinical impact on the burden of CKD in the UK.