Introduction: Chronic kidney disease (CKD) is a public health concern in China. Despite its heavy health and socioeconomic burden, early detection rate remains low. Point-of-care testing (POCT) for albuminuria using urine dipsticks represents a practical screening approach, promising to raise public awareness of kidney health and improve early detection rate. This study aims to evaluate the cost-effectiveness of Point-of-care (POC) albuminuria testing in China. Methods: We constructed and validated a microsimulation model for a hypothetical cohort of 100, 000 individuals aged 45 years and older over a 50-year horizon among both the general population and adults with diabetes. Screening strategies included annual usual care only (no screening) and POC albuminuria testing conducted every 1, 2, 5, or 10 years, or once in a lifetime. Model parameters were obtained from the published literature and existing data sources in China. In the model, we evaluated incremental cost-effectiveness ratios (ICERs) and health outcomes of POC albuminuria testing-including life years gained and decrease in cardiovascular disease (CVD) and kidney failure requiring replacement therapy (KFRT) events compared with usual care from a societal perspective. Results: Compared with usual care, POC albuminuria testing was generally cost-effective at a willingness-to-pay (WTP) threshold of 40, 119 (three times China's gross domestic product per capita). The ICERs ranged from 9432 to 26, 735 per quality-adjusted life year (QALY) among adults with diabetes, and from 11, 194 to 42, 157 per QALY among general population. Among all strategies evaluated, annual POC albuminuria testing initiated at age 45 years yielded the best cost-effectiveness. With respect to health outcomes, annual POC screening from age 45 years yielded incremental gains of 0. 193 and 0. 262 life-years in the general population and adults with diabetes, respectively, and prevented 37 and 18 cases of CVD per 1, 000 individuals, as well as 13 and 70 cases of KFRT per 10, 000 individuals. Conclusion: POC albuminuria testing was cost-effective compared with usual care in the Chinese population. Annual screening starting at age 45 years was considered the most cost-effective, contributing to better health outcomes and providing scientific evidence for developing national strategies for CKD prevention and intervention. I have no potential conflict of interest to disclose. I did not use generative AI and AI-assisted technologies in the writing process.
Weatherall et al. (Wed,) studied this question.