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Kidney Week

Abstract: PO0275

Modelling the Clinical and Economic Burden of Anaemia in Patients with CKD

Session Information

Category: Anemia and Iron Metabolism

  • 200 Anemia and Iron Metabolism

Authors

  • Darlington, Oliver T., Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom
  • Booth, David, Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom
  • Gabb, Peter David, Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom
  • Sanon, Myrlene, Otsuka Pharmaceutical Development and Commercialization, Inc., Princeton, New Jersey, United States
  • Michalopoulos, Efstathios N., Otsuka Pharmaceutical Development and Commercialization, Inc., Princeton, New Jersey, United States
  • Farag, Youssef MK, Akebia Therapeutics, Inc., Cambridge, Massachusetts, United States
  • Wang, Xinyu, Otsuka Pharmaceutical Europe Ltd., Slough, United Kingdom
  • McEwan, Philip, Health Economics and Outcomes Research Ltd., Cardiff, United Kingdom
Background


Chronic Kidney Disease (CKD) imposes a significant societal burden. Anemia is a common complication of CKD and is independently associated with poorer patient outcomes, including CKD progression, cardiovascular (CV) events and death. The objective of this study was to develop a natural history model to characterize the consequences of anemia in patients with CKD.

Methods


A lifetime Markov model was developed to estimate the economic impact of anemia. Two cohorts aged 58 years with CKD stage 3b were modelled with and without anemia (Hb 9-10 g/dL and Hb > 12 g/dL) to estimate differences in life expectancy (LE) and quality adjusted life years (QALYs), and event incidence. Hb level was linked to CKD progression, CV hospitalization and mortality using published data. Published direct costs and utility estimates associated with CKD and event incidence were incorporated, and costs were inflated to 2019 US dollars. Costs associated with anemia treatment such as erythropoiesis-stimulating agents or supplemental iron were not considered. Future costs and benefits were discounted at 3.0% per annum.

Results


Predicted LE was 10.21 years in patients with anemia compared to 12.36 years in patients without anemia, or a reduction of 2.15 years. Decreased patient LE and reduced quality of life with anemia resulted in 2.18 fewer QALYs. Time to end stage renal disease was 10.4 years with anemia and 12.5 years without anemia. Patients with anemia experienced 25 additional CV-related hospitalizations per 1,000 patients. Total lifetime costs were higher in the non-anemic cohort due to improved LE ($342,867 vs. $316,510), however, annual costs were lower with an undiscounted saving of $2,628 per year due to reduced CV event incidence and CKD management costs.

Conclusion


This analysis supports that those without anemia have increased LE and QALYs, and account for less costs to the healthcare system. Therefore, anemia management, aligned with clinical guidelines, has the potential for better outcomes for both the patient and the healthcare system.

Funding

  • Commercial Support