Abstract: PO0774
Economic Burden Associated with CKD Progression Based on Kidney Disease: Improving Global Outcomes (KDIGO) Risk Categories in Type 2 Diabetes
Session Information
- Diabetic Kidney Disease: Clinical
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Diabetic Kidney Disease
- 602 Diabetic Kidney Disease: Clinical
Authors
- Mullins, C. Daniel, University of Maryland Baltimore, Baltimore, Maryland, United States
- Pantalone, Kevin, Department of Endocrinology and Metabolism, Cleveland Clinic, Cleveland, Ohio, United States
- Betts, Keith A., Analysis Group Inc, Los Angeles, California, United States
- Song, Jinlin, Analysis Group Inc, Los Angeles, California, United States
- Chen, Yan, Analysis Group Inc, Los Angeles, California, United States
- Kong, Sheldon X., Bayer U.S. LLC, Whippany, New Jersey, United States
- Singh, Rakesh, Bayer U.S. LLC, Whippany, New Jersey, United States
Background
CKD progression adds substantial economic burden in T2D. This study evaluated the medical costs associated with CKD progression defined by KDIGO risk categories in patients with T2D and CKD.
Methods
A prevalent cohort of adult patients with T2D and CKD who had measures of eGFR and UACR indicating moderate or high KDIGO risk categories were identified from the Optum electronic health records database (Jan 2007- Dec 2019). CKD progression was defined as an increase in KDIGO risk category. Annualized costs for inpatient admissions, emergency room visits, and outpatient visits were evaluated for up to 2 years after the index date (i.e., the first record indicating CKD progression for progressors; the later of the first record indicating the patient’s risk category or two years before the end of follow-up for non-progressors).
Results
Among 218,624 patients with baseline moderate risk, 41,986 (19%) progressed to high risk and 3,102 (1%) progressed to very high risk; among 50,461 patients with baseline high risk, 14,241 (28%) progressed to very high risk. Compared to non-progressors, the annual incremental costs were $5,193 for patients progressed from moderate risk to high risk, $18,168 for moderate risk to very high risk, and $15,280 for high risk to very high risk (Figure 1). Inpatient costs were the major driver of incremental costs. CKD-related medical costs contributed to 28%, 34%, 42%, and 44% of total medical costs in the 4 groups, highest in patients who progressed to very high risk.
Conclusion
Patients with T2D and CKD in KDIGO moderate or high risk categories had significantly higher medical costs when they progressed to a higher KDIGO risk category compared to those without progression. Preventing progression could bend the cost curve in patients with T2D and CKD.
Funding
- Commercial Support –