Sood V, Braun L, Hogue S, Davis K, Copley-Merriman C, Lieberman B. Chronic kidney disease burdens patients, health care systems, and employers. Poster presented at the 2011 ISPOR 14th Annual European Congress; November 9, 2011. [abstract] Value Health. 2011 Nov; 14(7):A331.

OBJECTIVES: To elucidate patient and economic burden associated with chronic kidney disease (CKD) across countries.

METHODS: A targeted literature review using PubMed and desktop research was performed. Currency conversions were adjusted to 2010.

RESULTS: North American, European, and Asian studies were identified; most reports were from the United States (US). Advanced CKD (stages 3-5) adversely affects outcomes. As patient-reported outcomes (PROs) deteriorate, resource utilization (RU) and costs escalate. Across studies, patients with CKD report cognitive impairment, dementia, sleep disturbance, and emotional and physical dysfunction (PD), with PD being most pervasive. Compared with general populations across countries, Health-related Quality of Life (HRQOL) and other PROs decline in patients with CKD. Age, female gender, less education, lower income, unemployment, limited exercise, and comorbid illness are predictors of reduced HRQOL. RU and costs to healthcare systems and employers increase with CKD severity. Prior to (12-24 months) dialysis initiation, costs increase substantially due to hospitalization. Annual US total cost per patient (c/p/p) with CKD (stages 3-5) range from $6,026 (€4,927) to $30,398 (€24,855); annual Germany total c/p/p (stages 1-4) is €3,581 ($4,379), compared to €1,272 ($1,555) in those without CKD. The cost burden of CKD is rising. From 1993 to 2007, Medicare costs for patients with CKD increased by 5-fold. High healthcare costs (HC) and reduced productivity due to CKD, burdens employers. For employees with CKD (US), HCs range from $1,187 (€971) (stage 3) to $21,826 (€17,846) (stage 5) and work-hours missed per week often exceeds 10. The impact of CKD on patient and economic burden across countries is evident.

CONCLUSIONS: Patient and economic burden associated with CKD is considerable across countries. With disease progression and kidney-function decline, unfavorable outcomes arise. As evidenced by the high patient and economic burden of CKD, a large unmet need exists for new therapies and employee CKD-management programs.