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Abstract: TH-PO726

Economic and Humanistic Burden Among Individuals With CKD in the United States: A Systematic Literature Review

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health

Authors

  • Osenenko, Katherine M., Broadstreet HEOR, Vancouver, British Columbia, Canada
  • Chatterjee, Satabdi, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
  • Ray, Saurabh, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
  • Li, Tina, Broadstreet HEOR, Vancouver, British Columbia, Canada
  • Donato, Bonnie M.k., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
Background

Chronic kidney disease (CKD) is associated with substantial economic, humanistic, and clinical burden. While the clinical burden and direct medical costs are well characterized, less is known about the humanistic and economic burden, including lost productivity. The objective of this review was to synthesize contemporary estimates of economic and humanistic impact among individuals with CKD in the United States (US).

Methods

A systematic review was conducted using MEDLINE and Embase to identify studies reporting estimates of CKD economic or humanistic patient burden in the US, published between 2016-2021. Study selection and data extraction were performed in duplicate, in accordance with PRISMA guidelines. A grey literature search was conducted for the past 5 years. Characteristics of patients with CKD, and estimates of economic and humanistic burden, were summarized.

Results

From 4,880 abstracts, 38 eligible studies were included. Mean patient age ranged from 46.3-63.7 years; proportion of males ranged from 41.70-63.0%. Reported comorbidities included diabetes (23.0-55.8%), cardiovascular disease (20.5-63.0%), and hypertension (45.5-97.0%). Two studies reported out-of-pocket (OOP) expenditures for patients with CKD, estimated at $1,599 (mean) and $1,807 (median) annually (2022 USD), with more than 16% of patients reported to face high OOP burden. One study reported that 46.9% of non-elderly patients with CKD experienced financial hardship within the past year due to medical bills, with lack of health insurance being the strongest determinant; impacts included non-adherence and delayed/foregone medical care. Health-related quality of life (HRQoL) was assessed in 32 studies using a variety of instruments; high burden to patients with CKD was consistently demonstrated, with higher CKD stage associated with greater burden. Limited data were available on lost productivity.

Conclusion

The findings of this review demonstrate the high economic and humanistic burden to individuals with CKD, although HRQoL data were heterogenous and economic data were limited. Further research is needed to better characterize the burden to individuals with CKD, in particular the economic impact and lost productivity, as well as drivers of burden.