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Abstract: SA-PO280

Cost-Effectiveness Analysis of a Prognostic Risk Assessment Test for Diabetic Kidney Disease G1-G3b in the United States

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Cooper, Jacie T., Avalon Health Economics LLC, Morrristown, New Jersey, United States
  • Beltran, Karen, Avalon Health Economics LLC, Morrristown, New Jersey, United States
  • Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Schneider, John E., Avalon Health Economics LLC, Morrristown, New Jersey, United States
Background

KidneyIntelXTM was developed and validated to predict rapid progressive decline in kidney function in patients with early-stage diabetic kidney disease (DKD). KidneyIntelX can assist primary care providers to guide resource utilization and prescription of new therapeutic agents, and improve efficiency of care among physicians. We sought to develop a model that estimates the incremental cost-effectiveness of KidneyIntelX compared to risk stratification using eGFR and UACR (GAC).

Methods

We modeled a hypothetical cohort of 100,000 patients with DKD in stages G1/G2 with A2/A3, or G3a/G3b with A1-A3 that received a prognostic test (GAC vs. KidneyIntelX) one time at the start of the model and cardiorenal agents for treatment. We employed a 10-state Markov state transition structure, made up of the following states: Stages G1 through G5, dialysis, kidney transplant, cardiovascular death, and non-cardiovascular death. The model projects outcomes, including cardiovascular events, over a lifetime time horizon with a maximum patient age of 100 years old and presents results for both Medicare and Commercial payer perspectives.

Results

Our results showed that the average Medicare patient population would experience fewer dialysis starts and kidney transplants, increased life span, and increased quality adjusted life-span by using KidneyIntelX compared to GAC. Medicare patients would incur incremental costs of approximately -$428 per patient and incremental QALYs of 0.09. In the commercial scenario analyses, cost savings were about $14,116 per patient and QALY gains of 0.15, indicating that KidneyIntelX is a dominant strategy in comparison to GAC (Figure).

Conclusion

This analysis demonstrated that population-based KidneyIntelX testing for the prognosis of progression in a DKD G1-G3b population is a dominant strategy for both Medicare and commercial populations in comparison to prognosis relying on eGFR and UACR alone.

Funding

  • Commercial Support