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Kidney Week

Abstract: PO0776

Cardiovascular and CKD-Related Healthcare Costs for Patients with Type 2 Diabetes and CKD

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Singh, Rakesh, Bayer Corp, Whippany, New Jersey, United States
  • Song, Jinlin, Analysis Group Inc, Los Angeles, California, United States
  • Faust, Elizabeth, Analysis Group Inc, New York, New York, United States
  • Du, Yuxian, Bayer Corp, Whippany, New Jersey, United States
  • Kong, Sheldon X., Bayer Corp, Whippany, New Jersey, United States
  • Betts, Keith A., Analysis Group Inc, Los Angeles, California, United States
Background

Cardiovascular (CV) events and chronic kidney disease (CKD) management incur high medical costs in patients with type 2 diabetes (T2D) and CKD. This study aimed to provide reliable regression-based cost estimates of these events among patients with T2D and CKD.

Methods

This study used Optum Clinformatics® claims data from 52,599 adults with T2D and CKD identified during 2015-2019 and followed until disenrollment, death, or end of data availability. Medical costs (2020 USD) associated with CV events and CKD management were estimated using a generalized estimating equation model adjusting for age, sex, as well as CV complications and medical costs at baseline. Costs were assessed in 4-month cycles as commonly evaluated in clinical trials in this population, with acute event costs assessed in the first 4 months after the incident CV events and renal replacement therapies (RRT). Mortality costs were assessed in the last month prior to death.

Results

The estimated 4-month CKD management costs were $7,725 for stage 1 or 2, $8,928 for stage 3, $10,809 for stage 4, and $11,879 for stage 5 (without RRT). The estimated acute event costs for dialysis and kidney transplantation were $87,538 and $124,271, respectively. The costs decreased to $49,573 and $7,079 in subsequent 4-month cycles following dialysis initiation and kidney transplantation.
The estimated costs for acute CV events were $31,063 for heart failure, $21,087 for stroke, $21,016 for myocardial infarction, and $19,954 for atrial fibrillation ($30,500 with hospitalization and $5,162 without). In subsequent 4-month cycles, costs were $4,931 for heart failure, $2,327 for stroke, and $1,941 for myocardial infarction. The acute cost of hyperkalemia was $15,149 ($31,212 with hospitalization and $1,782 without).
In the month before death, the costs associated with CV-related death, renal-related death, and death from other causes were $17,031, $12,605, and $9,900, respectively.

Conclusion

CV events and CKD management incur significant healthcare costs for patients with T2D and CKD. The cost estimates from this study may support the parametrization of economic models and help clinicians determine the cost-effectiveness of interventions.

Funding

  • Commercial Support