Economic Evaluation of Egfr Control In Patients With Chronic Kidney Disease In Japan

OBJECTIVES: The aim of this study was to estimate economic impact of eGFR control in patients with chronic kidney disease (CKD) in Japan based on an epidemiological study and cost of medical care at each CKD stage. METHODS: Of the 2410 CKD patients, -53~≤-30% in 314 patients, and >-30~≤0% in 1153 patients. Baseline eGFR for each group of eGFR changes were 24.4, 22.2, and 30.0, respectively (K. Matsushita et al, Kidney Int., 2016). A Markov model for 60 age CKD patient which consists of health states for CKD stage III to V (end stage renal disease) was used to estimate the economic impact when the patients do not experience the eGFR reduction. The risk of CKD stage progression (e.g., from III to IV) in the model was based on the predicted absolute risk previously reported from Japanese CKD study. Information on costs for each CKD stage was extracted from Japanese literature. RESULTS: Expected total cost during lifetime horizon per patient was 78,675,229 yen, 76,902,293 yen, and 21,140,589 yen for patients experienced -53~≤-30%, and >-30~≤0% change in eGFR, respectively. If the patients do not experience the eGFR reduction, expected total cost during lifetime horizon per patient was 2,861,213 yen, 42,919,151 yen, and 8,792,078 yen, then the expected total cost reduction for patients of each category were 50,063,127 yen, 33,983,142 yen, and 12,348,511 yen, respectively. Therefore, the weighted average cost reduction of patients experienced -53~≤-30%, and >-30~≤0% change in eGFR was 18,831,423 yen. CONCLUSIONS: Our results demonstrate significant economic impact if the eGFR declines can be prevented in patients with CKD and suggest the importance of appropriate management to prevent CKD progression.