ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: FR-PO542

Cost-Utility of Real-Time Potassium Monitoring in Hemodialysis Patients

Session Information

Category: Fluid‚ Electrolyte‚ and Acid-Base Disorders

  • 1002 Fluid‚ Electrolyte‚ and Acid-Base Disorders: Clinical

Authors

  • Bamforth, Ryan J., Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Ferguson, Thomas W., Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
  • Komenda, Paul, Chronic Disease Innovation Centre, Winnipeg, Manitoba, Canada
Background

Patients with kidney failure requiring dialysis are at high risk for hyperkalemia, a result of elevated levels of potassium, which is associated with increased morbidity and mortality. Interventions aimed at early detection of hyperkalemic events may be useful to prevent these outcomes and their associated costs. As such, we performed a cost-utility analysis comparing an intervention where a real-time potassium monitoring device is administered in hemodialysis patients in comparison to usual care.

Methods

We performed a cost-utility analysis by developing a decision analytic microsimulation model from the perspective of the United States health care payer. Outcomes included the monthly break-even cost per patient of the proposed intervention and the incremental cost-effectiveness ratio (ICER) comparing use of the real-time potassium monitoring device to usual care. Costs associated with hyperkalemic events (emergency department and hospitalization specific) and dialysis were included. Utility estimates from a systematic review and meta-analysis were used to derive utilities for patients on hemodialysis. A reduction in hyperkalemic events of 25% was applied in the intervention scenario as a baseline effectiveness estimate, with a range between 10-50% considered in sensitivity analyses.

Results

Threshold analysis yielded a monthly break-even cost of $689.56 US dollars per patient in the base case scenario. In addition, the microsimulation model found the intervention provided 0.04 additional quality-adjusted life-years (QALYs), and as such at any price point below or equal to the break-even cost the intervention was dominant in comparison to usual care. When altering effectiveness estimates between a reduction of hyperkalemic events between 10% to 50%, the monthly break-even cost ranged from $265.36 to $1387.90 USD respectively.

Conclusion

Implementing a real-time potassium monitoring device in hemodialysis patients to prevent hyperkalemic events has the potential for cost savings and increased quality of life from the perspective of the Unites States health care payer.

Funding

  • Commercial Support