Inside CKD: Cost-Effectiveness of Multinational Screening for CKD

Figures

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  Figure 1. Incremental change in kidney replacement therapy (KRT) prevalence by modality in the general population per 100,000 people by screening strategy (unweighted average across considered 31 countries or regions). The simulated cohort comprised only people without a CKD diagnosis who are eligible for screening and not all patients are assumed to undergo screening. Negative values indicate an incremental decrease in the number of individuals initiating KRT resulting from a screening strategy compared to current practice. CKD, chronic kidney disease; eGFR: estimated glomerular filtration rate; KRT, kidney replacement therapies; UACR: urine albumin-to-creatinine ratio.

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  Figure 2. Incremental per-patient accrual of LYs and QALYs in the general population after screening for CKD. Solid lines represent the mean value across 31 countries or regions, the shaded regions pertain to the range of values observed in the base case analyses across countries. LY, life years; QALY, quality-adjusted life year.

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  Figure 3. Cost-effectiveness of screening, in general population and high-risk subgroups, across 31 countries or regions, expressed as (a) pairwise ICERs as a function of WTP threshold versus current practice, (b) incremental net monetary benefit between the pairwise analyses. Green color indicates an incremental cost-effective ratio that is below the WTP threshold meaning that the strategy would be considered cost-effective according to the study criteria, with bordered squares indicating analyses that were not considered cost-effective. The net monetary benefit characterizes the relative value of cost-effective screening interventions and suits evaluation of pairwise analyses. Green color indicates that the net monetary benefit of the “2 eGFR and 1 UACR” is at least double the “2 eGFR only” strategy, yellow color indicates that they are comparable, and red indicates that “2 eGFR only” strategies are better value. CVD, cardiovascular disease; eGFR, estimated glomerular filtration rate; HTN, hypertension; ICER, incremental cost-effectiveness ratio; T2D, type 2 diabetes; WTP, willingness-to-pay threshold; UACR, urine albumin-to-creatinine ratio; UAE, United Arab Emirates; UK: United…

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  Figure 4. Evolution of the cost effectiveness of screening over time for the “2 eGFR only” (red) and “2 eGFR and 1 UACR” (blue) strategies in the general population across 31 countries or regions. Solid lines indicate the mean value across countries or regions; the grey shaded area indicates the range of estimates across the 31 countries or regions; the grey dotted line indicates the WTP threshold, with cost-effective estimates falling below the line. Screening occurs in the index year, with outcomes assessed in subsequent years. eGFR, estimated glomerular filtration rate; ICER, incremental cost-effectiveness ratio; UACR, urine albumin to creatinine ratio; WTP, willingness-to-pay threshold.