Abstract: TH-PO1047
Evaluating the Economic Impact of CKD on Germany's Health Care System: A 2023 Claims Data Analysis
Session Information
- CKD: Epidemiology, Risk Factors, and Other Conditions
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Kielstein, Jan T., Academic Teaching Hospital Braunschweig, Braunschweig, NDS, Germany
- Müller, Marco, WIG2 GmbH – Scientific Institute for Health Economics and Health System Research, Leipzig, Germany
- Schultze, Michael, ZEG – Berlin Center for Epidemiology and Health Research GmbH, Berlin, BE, Germany
- Stengel, Doreen, AstraZeneca GmbH, Hamburg, HH, Germany
- Birnbaum, Jakob, AstraZeneca GmbH, Hamburg, HH, Germany
- Banas, Bernhard, Universitatsklinikum Regensburg, Regensburg, BY, Germany
- Banas, Miriam C., Universitatsklinikum Regensburg, Regensburg, BY, Germany
Background
Chronic kidney disease (CKD) places a significant burden on Germany's healthcare system. Nonetheless data on the costs associated with CKD patients are outdated, making political decisions regarding resource allocation for optimizing CKD patient care more difficult. This secondary analysis of claims data aims to examine the costs associated with CKD patients within the German healthcare system.
Methods
The real-world data analysis is based on a representative claims database from German statutory health insurances in 2023. CKD patients were identified by at least one disease-defining ICD-10 code. All metrics have been projected to national level by weighting individuals based on age, gender and regionality. Costs were reported in USD based on European Central Bank rate of 1€ = 1,1050$ (29.12.2023). Metrics include direct costs from insurances for inpatient and outpatient care, medication, sickness benefits and other costs.
Results
In 2023, patients with CKD caused $69.1B in costs. As expected, cost increased with CKD severity from stage 1-3: $2.1B, $9.9B, and $29.1B. Total costs for patients in stage 4 and 5 were $10.1B each and stage unknown incurred cost of $7.9B. Per patient, costs in stage 3 were $17k, tripling to $50k in stage 5. When comparing CKD patients, those without HF and T2DM had the lowest average costs at $12k, while those with both conditions had the highest costs at $25k. Inpatient care was the major cost contributor at $30.4B, surpassing outpatient care, prescriptions, sickness benefits, and other costs. While inpatient care remained the primary cost factor across all stages, in stage 5, outpatient costs nearly matched likely due to renal replacement therapy.
Conclusion
The analysis highlights the economic burden CKD patients impose on Germany's healthcare system. High hospitalization costs emphasize the need for guideline-directed medical therapy (GDMT) with ACEi/ARB and SGLT2i to potentially reduce costs, as clinical trials show significant hospitalization reductions. The true cost is likely underestimated due to i) undiagnosed CKD patients and ii) analysis of only direct insurance costs. Policymakers and HCPs must urgently implement screening for at-risk populations and early GDMT initiation, as these patients account for 18.7% of Germany’s health insurance spending.
Funding
- Commercial Support – AstraZeneca