Healthcare Costs Higher in Patients with ADPKD and Advanced Renal Dysfunction

In patients with autosomal dominant polycystic kidney disease (ADPKD), the progressive nature of declining kidney function is associated with increased risk of cardiovascular events and mortality. Patrick Gagnon-Sanschagrin, BSc, and colleagues recently conducted an analysis to examine the use of healthcare resources and costs associated with increasing renal dysfunction in patients with ADPKD. Results were reported online at the NKF Spring Clinical Meetings. The report was titled Substantial Excess Healthcare Costs in Commercial and Medicare Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) with Advanced Renal Dysfunction.

The researchers utilized IBM MarketScan® Commercial and Medicare Advantage Supplemental Databases from January 1, 2015, to December 31, 2107, to conduct a retrospective matched cohort claims analysis. Patients with ADPKD were eligible for the analysis if they had continuous enrollment and two International Classification of Diseases, Tenth Edition, Clinical Modification diagnosis codes for ADPKD.

Each patient with ADPKD was matched with up to three different patients without ADPKD (controls) by age, sex, region of residence, insurance plan, and calendar year. Differences in costs per patient per year (PPPY) between cohorts were estimated using index renal function stage.

The analysis included 7861 eligible patients with ADPKD and 22,928 controls in the commercial cohorts and 1366 eligible patients with ADPKD and 3922 controls in the Medicare Advantage cohorts. Costs in the ADPKD cohorts were higher than in the control cohorts.

There were significant variations in costs by index renal function stage. Total cost differences incurred among patients receiving dialysis were 34 to 37 times greater compared with patients with CKD stage 1 (commercial: $205,073 PPPY vs $6024 PPPY; Medicare: $259,974 PPPY vs $6984 PPPY).

In conclusion, the researchers said, “This study supports previous estimates of the excess economic burden among patients with ADPKD. Compared with controls, patients with ADPKD incur higher costs in both commercial and Medicare plans and the costs increase with renal impairment. Interventions to prevent loss of renal function early in the disease process have the potential to reduce substantial healthcare charges.”

Source: Gagnon-Sanschagrin P, Liang Y, Sanon M, Oberdhan D, Cloutier M. Substantial excess healthcare costs in commercial and Medicare patients with autosomal dominant polycystic kidney disease (ADPKD) with advanced renal dysfunction. Abstract of a presentation at the National Kidney Foundation 2020 Spring Clinical Meetings; abstract #378.