PUK11 - ECONOMIC BURDEN OF CHRONIC KIDNEY DISEASE RELATED COMPLICATIONS AND THERAPIES IN CHINA: QUANTIFYING THE COSTS OF CARDIOVASCULAR EVENTS, BLOOD TRANSFUSION FOR ANEMIA AND DIALYSIS

Abstract

Our objective was to estimate the costs of common chronic kidney disease (CKD)-related complications and therapies (cardiovascular (CV) events, blood transfusion for anemia, and dialysis) in China, for use in health economic analysis. This retrospective observational study used inpatient and outpatient insurance claims data from the China Health Insurance Research Association (CHIRA) in 2015. Adult patients with a CKD diagnosis were included. For patients with a hospitalization for CV events between 01/01/2015 and 30/09/2015, total inpatient costs per hospitalization were calculated, stratified by CV event type and dialysis status. Outpatient costs were determined for the three months post hospital discharge. Mean monthly costs before hospitalization were calculated for a patient subset with hospital admission after 01/04/2015. Furthermore, the cost of red blood cell transfusion (RBCT) during anemia-related hospitalizations was determined. Finally, monthly health care costs, including dialysis costs, were calculated for patients with ≥3 consecutive months with dialysis records. Among 31,886 CKD patients included in 2015, 2,871 patients had a CV hospitalization. The overall mean (median) cost per hospitalization was ¥14,488 (¥7871). Myocardial infarction was the costliest CV event (mean/median inpatient cost ¥29,203/¥13,046). Mean monthly outpatient costs per patient were higher post discharge (1st month: ¥264; 2nd month: ¥251; 3rd month: ¥228) than before the hospitalization (¥188.10; based on patient subset). Among the 1,227 patients with anemia-related hospitalizations with RBCT, the mean/median cost of blood products was ¥1,895/¥960 per patient per hospitalization. The 3,447 dialysis patients in our dataset incurred a mean/median monthly health care cost of ¥10,235/¥8,002 per patient, of which ¥5,874/¥5,240 were dialysis costs. Hemodialysis was more costly than peritoneal dialysis (mean/median monthly costs ¥6,096/¥5,348 vs. ¥3,861/¥3,939, respectively). Using high-quality insurance data from China, we quantified the costs of common CKD-related complications and therapies, which are major contributors to the economic burden of CKD.