Abstract: SA-PO1170
Economic Burden of Cardiovascular-Kidney-Metabolic Disease Among US Medicare Beneficiaries: A Systematic Literature Review (SLR)
Session Information
- CKD: SGLT2 Inhibitors and GLP-1 RAs for Kidney Health
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials
Authors
- Bengtson, Lindsay GS, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
- Bjornson, Alison, Broadstreet HEOR, Vancouver, British Columbia, Canada
- Szabo, Shelagh, Broadstreet HEOR, Vancouver, British Columbia, Canada
- Friesen, Michael, Broadstreet HEOR, Vancouver, British Columbia, Canada
- Murphy, Conor, Broadstreet HEOR, Vancouver, British Columbia, Canada
- Donato, Bonnie M.k., Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, United States
Background
Chronic kidney disease (CKD), type 2 diabetes (T2DM), and heart failure (HF) are substantial contributors to US Medicare spending. While these conditions have complex interrelationships and amplifying factors, how their combined occurrence impacts Medicare costs is unclear. The objective was to characterize the evidence of the economic burden among Medicare beneficiaries with CKD, T2DM, and/or HF.
Methods
An SLR was conducted using MEDLINE/Embase to identify published (2019-2024) estimates of direct health care costs among Medicare beneficiaries with CKD, T2DM, and/or HF. Costs were adjusted to 2024 USD.
Results
Of 2,651 publications identified, 47 met the PECOS (population, exposure, comparator, outcomes, study design) criteria, focusing on beneficiaries with: >2 conditions, in four studies; CKD, five; end-stage renal disease (ESRD), 16; T2DM, five; and HF, 25. Forty-six studies reported mean per-patient-per-year (PPPY) costs, and three Medicare spending. For beneficiaries with >2 conditions, total PPPY costs increased with the progression from T2DM and/or CKD to ESRD and/or HF (Figure). Increased costs were driven by hospitalizations, poor adherence, and dialysis/kidney transplant (KT). For example, in the study of FFS beneficiaries with T2DM-related comorbidities, those with T2DM+KT incurred the highest PPPY costs ($146,549), followed by T2DM+dialysis ($132,025), T2DM+HF ($58,219), then T2DM+CKD ($49,789). Across the identified studies, the maximum mean total PPPY cost was $18,786, $31,753, and $60,229 among FFS beneficiaries with T2DM, any-stage CKD, and chronic HFrEF, respectively. One study reported Medicare spending among beneficiaries with >2 conditions, and HF was the costliest T2DM-related comorbidity (18% of T2DM spending: $44 billion).
Conclusion
Direct costs among Medicare beneficiaries with CKD, T2DM, and/or HF are substantial, especially with the accumulation of additional cardiovascular-kidney-metabolic conditions. Early screening and intervention for T2DM and/or CKD, impact disease progression and thereby costly complications like HF and ESRD.
Funding
- Commercial Support – Boehringer Ingelheim