Cost Utility Analysis of Chronic Kidney Diseses Screening

Abstract

Abstract: Introduction: Chronic kidney disease (CKD) is a worldwide public health problem. CKD annually imposes a significant economic burden on health system in Iran. Objective: Given the high prevalence of this disease in Iran, this study aims to assess the cost effectiveness of one-off CKD screening in the general population.

Material and method: cost effectiveness analysis in a cohort simulated subjects aged from 40 to 80 years was carried out to compare screening of CKD and no screening in the general population. A Markov model simulating was developed to compare GFR, ACR, UAC, and Dipstick. Outcomes were reported in quality-adjusted life years (QALYs) and incremental cost- effectiveness ratio (ICER). Probabilistic sensitivity analysis (PSA) was used to account for uncertainty in multiple parameters. Annual discount rate of 3/5% were used. Cost are evaluated from the health care system perspective.

Result: incremental cost- effectiveness ratio (ICER) of CKD screening compared with no screening were calculated as IRR 15,422,228/ QALY for GFR test. For GFR, ACR, UAC, and Dipstick QALY gained was 10/7, 10/68, 10/76, 10/62 respectively. Taking a threshold to judge cost-effectiveness according to world health organization recommendation, i.e. one times gross domestic product per capita (IRR 189 million), GFR test is cost- effective.

Conclusion: population based screening for chronic kidney disease with assessment of estimated glomerular filtration rate is cost effective.