The cost to government and society of chronic kidney disease stage 1-5, a national cohort study

Abstract

Background:Costs associated with chronic kidney disease (CKD) are not well docu-mented. Understanding such costs is important to inform economic evaluations ofprevention strategies and treatment options.Aim:To estimate the costs associated with CKD in Australia.Methods:We used data from the 2004/2005 AusDiab study, a national longitudinalpopulation-based study of non-institutionalised Australian adults aged≥25 years. Weincluded 6138 participants with CKD, diabetes and healthcare cost data. The annual ageand sex-adjusted costs per person were estimated using a generalised linear model. Costswere inflated from 2005 to 2012 Australian dollars using best practice methods.Results:Among 6138 study participants, there was a significant difference in theper-person annual direct healthcare costs by CKD status, increasing from $1829 (95%confidence interval (CI): $1740–1943) for those without CKD to $14 545 (95% CI:$5680–44 842) for those with stage 4 or 5 CKD (P<0.01). Similarly, there was asignificant difference in the per-person annual direct non-healthcare costs by CKD statusfrom $524 (95% CI: $413–641) for those without CKD to $2349 (95% CI: $386–5156)for those with stage 4 or 5 CKD (P<0.01). Diabetes is a common cause of CKD and isassociated with increased health costs. Costs per person were higher for those withdiabetes than those without diabetes in all CKD groups; however, this was significantonly for those without CKD and those with early stage (stage 1 or 2) CKD.Conclusion:Individuals with CKD incur 85% higher healthcare costs and 50% highergovernment subsidies than individuals without CKD, and costs increase by CKD stage.Primary and secondary prevention strategies may reduce costs and warrant furtherconsideration.