A simulation model to estimate cost-offsets for a disease-management program for chronic kidney disease

Expert Rev Pharmacoecon Outcomes Res. 2015 Apr;15(2):341-7. doi: 10.1586/14737167.2015.972375. Epub 2014 Nov 29.

Abstract

Aim: The aim of this paper is to develop a simulation model that analyzes cost-offsets of a hypothetical disease management program (DMP) for patients with chronic kidney disease (CKD) in Germany compared to no such program.

Methods: A lifetime Markov model with simulated 65-year-old patients with CKD was developed using published data on costs and health status and simulating the progression to end-stage renal disease (ESRD), cardiovascular disease and death. A statutory health insurance perspective was adopted.

Results: This modeling study shows considerable potential for cost-offsets from a DMP for patients with CKD. The potential for cost-offsets increases with relative risk reduction by the DMP and baseline glomerular filtration rate. Results are most sensitive to the cost of dialysis treatment.

Conclusion: This paper presents a general 'prototype' simulation model for the prevention of ESRD. The model allows for further modification and adaptation in future applications.

Keywords: chronic kidney disease; disease management; simulation model.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disease Progression
  • Germany
  • Glomerular Filtration Rate
  • Humans
  • Insurance, Health / economics
  • Kidney Failure, Chronic / economics
  • Kidney Failure, Chronic / prevention & control
  • Markov Chains*
  • Models, Economic*
  • Renal Dialysis / economics
  • Renal Insufficiency, Chronic / economics
  • Renal Insufficiency, Chronic / physiopathology
  • Renal Insufficiency, Chronic / therapy*