Retrospective Study On Italian Adpkd Disease Management Cost (REINA STUDY)

OBJECTIVES: The aim of this study was to estimate the economic burden of Autosomal dominant polycystic kidney disease (ADPKD) in Italy, analyzing direct costs according to progression stage of chronic kidney disease (CKD).The primary endpoint was the average annual cost per patient with ADPKD in Italy. The secondary endpoint was represented by the average annual cost per patient suffering from ADPKD for CKD I to CKD V (not under dialysis), dialysis and post-transplant stage. METHODS: This retrospective, observational study was carried out by gathering data through a pre-specified Case Report Form (CRF) in six Italian hospitals. Costs associated with ADPKD were estimated based on identified cost drivers and the analysis was performed using the Activity-Based Costing method. Inpatient and outpatient resource consumption was collected for each patient during the period 2012-2015. Direct costs were then calculated from the perspective of the Italian National Health Service (NHS). RESULTS: 191 patients were enrolled. The analysis estimated an average annual cost associated with ADPKD management of € 7,921. The average annual cost of patients under dialysis was € 27,353, followed by post-trasplantation and CKD V patients (respectively 6 22,793 and e 12,658), CKD IV (6 7,320) and finally CKD III, CKD II, CKD I (respectively € 723.75, € 674.5 and f 159.7). Costs increased with disease progression, except for post-transplant stage.The outpatient specialist care (including dialysis) represented the highest impact on total costs, followed by pharmacological therapies and hospitalizations. CONCLUSIONS: The study underlined the relevant economic burden of ADPKD and its direct correlation with disease stage, suggesting the importance of slowing down disease progression, both for patient in terms of quality of life and the NHS budget.