Back
Chronic Kidney Disease (CKD) affects around one in ten people around the world. However, many cases remain undiagnosed. Annual CKD screening is recommended in high-risk groups but is often underperformed due to limited access to screening resources. New digital solutions could accelerate diagnosis by identifying high-risk patients earlier. The objective of this project was to carry out a cost-effectiveness analysis across 6 countries of a CKD screening programme using a globally validated digital solution developed by Gendius, the CKD screening prioritizer, compared with standard diagnosis and care.
Six virtual populations, representative of Australia, Brazil, Mexico, Saudi Arabia, South Korea and UAE, were generated using the previously validated Inside CKD microsimulation. Each individual was assigned an age, sex, CKD stage, comorbidity status (type 2 diabetes, hypertension) and a probability of being diagnosed. Direct healthcare costs were assigned based on an individual’s health status each year. An intervention was designed in which “high-risk” type 2 diabetes patients were identified using a validated digital solution, and subsequently referred for CKD testing (estimated glomerular filtration rate and urine albumin-to-creatinine ratio) and treatment (renin angiotensin system blockers) if diagnosed. The digital solution uses five universal inputs (age, sex, blood pressure, body mass index and duration of type 2 diabetes) to identify patients at ‘high-risk’ of having CKD. The health and economic benefits of introducing the digital solution were quantified and these epidemiological, quality of life and cost outputs were compared with the standard diagnosis and care scenario.
Compared with standard diagnosis and care, CKD screening using the validated digital solution followed by treatment was cost-effective in people defined as ‘high-risk’ in all six countries. For example, in Australia, using a willingness-to-pay threshold of $50,000AUD per additional quality adjusted life year (QALY), the incremental cost-effectiveness ratio was estimated at ~$6,000AUD/QALY. The digital tool would also add value to the patient and payers. For example, using a lifetime horizon, compared with standard diagnosis and care, the total cumulative quality-adjusted life years gained would equate to ~32,000, 510,000 and 59,000 in Australia, Brazil and Saudi Arabia, respectively. Additionally, in Saudi Arabia, which is currently developing its primary care system, the intervention would save around 21 primary care visits per patient overall. The full set of results for the six countries will be presented.
Targeted CKD screening via an easy-to-use digital solution may be a cost-effective way to improve patient outcomes as well as reduce time and cost to healthcare practitioners. Demonstration of effectiveness in various real world, country-specific contexts will be required.