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Abstract: PO0499

Healthcare Resource Utilization and Costs in a DAPA-CKD-Like Population Using a Contemporary US Healthcare Cohort

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Olufade, Tope, AstraZeneca, Wilmington, North Carolina, United States
  • Lamerato, Lois, Henry Ford Health System, Detroit, Michigan, United States
  • Garcia Sanchez, Juan Jose, AstraZeneca UK Ltd, Cambridge, Cambridgeshire, United Kingdom
  • Jiang, Like, AstraZeneca, Wilmington, North Carolina, United States
  • Huang, Joanna C., AstraZeneca, Wilmington, North Carolina, United States
  • Nolan, Stephen, AstraZeneca UK Ltd, Cambridge, Cambridgeshire, United Kingdom
Background

The DAPA-CKD Trial is the first SGLT-2i renal outcome trial to test the efficacy and safety of an SGLT-2i, dapagliflozin, in patients with diagnosed CKD with and without T2D.
The objective of this study is to assess the healthcare resource utilization and cost in a “DAPA-CKD-like population” (eGFR 25-75ml/min/1.73m2 and UACR 200-5000mg/g) using a contemporary US healthcare system.

Methods

Data from the Henry Ford Health System (HFHS) were used to identify patients with CKD stages 2 through 4 between 2006 and 2016 (based on eGFR labs) and patients were followed through 2018. Patients with no confirmatory eGFR > 90 days from index date, death within 30 days, history of renal transplant, and evidence of renal replacement therapy, or progression to CKD stage 5 during the baseline period (6 months pre or post index date) were excluded.
Cumulative primary and secondary utilization was evaluated for all patients during the follow-up time. Annual utilization rates are the total observed utilization divided by follow-up time. Billing records with HFHS were used to estimate costs.

Results

6,557 patients (mean age 62.9 years, 46.2% male) met the eligibility criteria and are included in the study cohort. The population was stratified by UACR (0-<30, 30–199, 200–5,000mg/g). The DAPA-CKD-like population (200-5000mg/g) was associated with significantly higher annualized per-patient healthcare costs, $39,222/yr (UACR 200-5000mg/g) vs. $19,547/yr (UACR <30mg/g). Persons in the highest UACR category were almost three times more likely to have a hospital admission compared to the lowest (rates 0.55/year vs. 0.20/year, respectively; see Table 1).

Conclusion

This analysis of a contemporary US healthcare system demonstrated that there exists a high disease burden in the DAPA-CKD-like population as seen by the substantial increase in healthcare resource utilization and costs compared to other cohorts of patients with a lower UACR. These results highlight the need for innovative therapies to improve patient outcomes in this high risk population.

Funding

  • Commercial Support