ECONOMIC EVALUATION OF A NEPHROPROTECTION PROGRAM IN PATIENTS OF THE MEXICAN INSTITUTE OF SOCIAL SECURITY WITH CHRONIC KIDNEY DISEASE
Author(s)
Azamar Alonso A1, Mena Brito J2, Soto Molina H3
1National Institute of Public Health, Cuernavaca, Mexico, 2Mexican Institute of Social Security, Federal District, Mexico, 3Universidad Autónoma Metropolitana, Mexico City, Mexico
OBJECTIVES: Clinic evidence shows that nephroprotection programs in patients with chronic kidney disease improve patient’s health, life expectancy and reduce hospitalizations and early deaths. In Mexico, there are few nephroprotection programs. The purpose of this study was to analyze a nephroprotection program in patients of the Mexican Institute of Social Security with chronic kidney disease aimed to improve life expectancy and to reduce hospitalizations and early deaths. METHODS: The study design was a cost-effectiveness analysis from the governmental perspective. All the costs were obtained from the Diagnosis-related groups that Mexican Institute of Social Security publishes. Costs were expressed in 2013 constant USD. A Markov model with forty eight monthly cycles was used. We considered five chronic kidney disease stages according to US National Kidney Foundation and also death stage. Parameters were obtained from other nephroprotection programs and also from the Mexican Institute of Social Security statistics. Years life gained, hospitalizations and early deaths avoided ICER were estimated and discounted at 5% annual rate. Univariate sensitivity analysis for costs was performed. Also we conducted budget impact analysis. RESULTS: The nephroprotection program was cost-saver for cost per year life gained (ICER= $-1,477) and for hospitalizations avoided (ICER= $-4,984) and cost-effective for early death avoided (ICER=$22,738). The program increases thirteen months life expectancy, reduces 50% hospitalizations and avoids 21,118 deaths in a four-year horizon. The hospitalizations avoided also allow increasing hospital supply in 67%. The budget impact analysis showed that the program could achieve savings of 42% for the Institute. CONCLUSIONS: The nephroprotection program could improve patient’s health and reduce disease progression, therefore, it could be considered for implementation in the Mexican Institute of Social Security.
Conference/Value in Health Info
2014-05, ISPOR 2014, Palais des Congres de Montreal
Value in Health, Vol. 17, No. 3 (May 2014)
Code
PHS52
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Urinary/Kidney Disorders