Kidney and Blood Pressure Research
Original Paper
Healthcare Expenditure and Resource Utilization in Patients with Anaemia and Chronic Kidney Disease: A Retrospective Claims Database AnalysisWish J.a · Schulman K.b · Law A.c · Nassar G.daDivision of Nephrology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, bThomson Medstat, Cambridge, Mass., cMedical Data Analytics, Roche, Nutley, N.J. and dKidney Institute, Houston, Tex., USA
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: July 17, 2008
Accepted: December 02, 2009
Published online: April 17, 2009
Issue release date: June 2009
Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 3
ISSN: 1420-4096 (Print)
eISSN: 1423-0143 (Online)
For additional information: https://www.karger.com/KBR
Abstract
Background/Aims: We conducted a retrospective claims database analysis to examine the association of anaemia and anaemia management with healthcare expenditure and utilization in patients with chronic kidney disease (CKD) before the onset of dialysis. Methods: Claims data on patients (aged ≥15 years) with CKD were collected from the Medstat Marketscan® Commercial and Medicare Databases between 2000 and 2005. Using these data, patients were evaluated for anaemia of CKD, anaemia treatment status and healthcare costs and use. Results: Of the 37,105 CKD patients, 9,807 (26%) had incident anaemia; 59% of these received at least one type of anaemia treatment, with 48% receiving an erythropoiesis-stimulating agent. The total adjusted per patient per month healthcare expenditure for all CKD patients was USD 2,749. Patients with anaemia had significantly greater overall expenditure, which was 38% higher than those without anaemia. Total expenditure was 17% higher for untreated versus treated anaemic patients, largely due to higher inpatient expenditure in the untreated cohort. Conclusion: This analysis suggests that the presence of anaemia is associated with greater medical expenditure in patients with CKD. However, we found that anaemia management may help to lower inpatient costs associated with anaemia in the CKD population.
© 2009 S. Karger AG, Basel
Related Articles:
References
- Coresh J, Astor BC, Greene T, Eknoyan G, Levey AS: Prevalence of chronic kidney disease and decreased kidney function in the adult US population: Third National Health and Nutrition Examination Survey. Am J Kidney Dis 2003;41:1–12.
-
US Renal Data System: USRDS 2007 Annual Data Report: Atlas of End-Stage Renal Disease in the United States. Bethesda, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, 2007.
- Collins AJ, Li S, Ebben J, Ma JZ, Manning W: Hematocrit levels and associated Medicare expenditures. Am J Kidney Dis 2000;36:282–293.
- Khan SS, Kazmi WH, Abichandani R, Tighiouart H, Pereira BJ, Kausz AT: Health care utilization among patients with chronic kidney disease. Kidney Int 2002;62:229–236.
- London R, Solis A, Goldberg GA, Wade S, Ryu S: Health care resource utilization and the impact of anemia management in patients with chronic kidney disease. Am J Kidney Dis 2002;40:539–548.
- Robbins JD, Kim JJ, Zdon G, Chan WW, Jones J: Resource use and patient care associated with chronic kidney disease in a managed care setting. J Manag Care Pharm 2003;9:238–247.
- Hunsicker LG: The consequences and costs of chronic kidney disease before ESRD. J Am Soc Nephrol 2004;15:1363–1364.
- Schoolwerth AC, Engelgau MM, Hostetter TH, Rufo KH, Chianchiano D, McClellan WM, Warnock DG, Vinicor F: Chronic kidney disease: a public health problem that needs a public health action plan. Prev Chronic Dis 2006;3:A57.
- McClellan W, Aronoff SL, Bolton WK, Hood S, Lorber DL, Tang KL, Tse TF, Wasserman B, Leiserowitz M: The prevalence of anemia in patients with chronic kidney disease. Curr Med Res Opin 2004;20:1501–1510.
- Foley RN, Parfrey PS, Harnett JD, Kent GM, Murray DC, Barre PE: The impact of anemia on cardiomyopathy, morbidity, and mortality in end-stage renal disease. Am J Kidney Dis 1996;28:53–61.
- Levin A, Singer J, Thompson CR, Ross H, Lewis M: Prevalent left ventricular hypertrophy in the predialysis population: identifying opportunities for intervention. Am J Kidney Dis 1996;27:347–354.
- Levin A, Thompson CR, Ethier J, Carlisle EJ, Tobe S, Mendelssohn D, Burgess E, Jindal K, Barrett B, Singer J, Djurdjev O: Left ventricular mass index increase in early renal disease: impact of decline in hemoglobin. Am J Kidney Dis 1999;34:125–134.
- Luthi JC, Flanders WD, Burnier M, Burnand B, McClellan WM: Anemia and chronic kidney disease are associated with poor outcomes in heart failure patients. BMC Nephrol 2006;7:3.
- Mohanram A, Zhang Z, Shahinfar S, Keane WF, Brenner BM, Toto RD: Anemia and end-stage renal disease in patients with type 2 diabetes and nephropathy. Kidney Int 2004;66:1131–1138.
- Pendse S, Singh AK: Complications of chronic kidney disease: anemia, mineral metabolism, and cardiovascular disease. Med Clin North Am 2005;89:549–561.
- Xia H, Ebben J, Ma JZ, Collins AJ: Hematocrit levels and hospitalization risks in hemodialysis patients. J Am Soc Nephrol 1999;10:1309–1316.
- Drueke TB, Eckardt KU, Frei U, Jacobs C, Kokot F, McMahon LP, Schaefer RM: Does early anemia correction prevent complications of chronic renal failure? Clin Nephrol 1999;51:1–11.
- Furuland H, Linde T, Ahlmen J, Christensson A, Strombom U, Danielson BG: A randomized controlled trial of haemoglobin normalization with epoetin alfa in pre-dialysis and dialysis patients. Nephrol Dial Transplant 2003;18:353–361.
- Provenzano R, Garcia-Mayol L, Suchinda P, Von Hartitzsch B, Woollen SB, Zabaneh R, Fink JC: Once-weekly epoetin alfa for treating the anemia of chronic kidney disease. Clin Nephrol 2004;61:392–405.
- National Kidney Foundation: KDOQI clinical practice guidelines and clinical practice recommendations for anemia in chronic kidney disease. Am J Kidney Dis 2006;47:S11–S145.
- Drueke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, Burger HU, Scherhag A: Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med 2006;355:2071–2084.
- Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, Reddan D: Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med 2006;355:2085–2098.
- Barr CE, Schulman K, Iacuzio D, Bradley JS: Effect of oseltamivir on the risk of pneumonia and use of health care services in children with clinically diagnosed influenza. Curr Med Res Opin 2007;23:523–531.
- Berndt ER, Bir A, Busch SH, Frank RG, Normand SL: The medical treatment of depression, 1991–1996: productive inefficiency, expected outcome variations, and price indexes. J Health Econ 2002;21:373–396.
- Coresh J, Byrd-Holt D, Astor BC, Briggs JP, Eggers PW, Lacher DA, Hostetter TH: Chronic kidney disease awareness, prevalence, and trends among US adults, 1999–2000. J Am Soc Nephrol 2005;16:180–188.
- Nissenson AR, Pereira BJ, Collins AJ, Steinberg EP: Prevalence and characteristics of individuals with chronic kidney disease in a large health maintenance organization. Am J Kidney Dis 2001;37:1177–1183.
- Duh MS, Mody SH, Scott McKenzie R, Lefebvre P, Gosselin A, Tak Piech C: Dosing patterns and costs of erythropoietic agents in patients with chronic kidney disease not on dialysis in managed care organizations. Clin Ther 2006;28:1443–1450.
- Papatheofanis FJ, McKenzie RS, Mody SH, Suruki RY, Piech CT: Dosing patterns, hematologic outcomes, and costs of erythropoietic agents in predialysis chronic kidney disease patients with anemia. Curr Med Res Opin 2006;22:837–842.
- Dowling TC: Prevalence, etiology, and consequences of anemia and clinical and economic benefits of anemia correction in patients with chronic kidney disease: an overview. Am J Health Syst Pharm 2007;64:S3–S7; quiz S23–S25.
- Ershler WB, Chen K, Reyes EB, Dubois R: Economic burden of patients with anemia in selected diseases. Value Health 2005;8:629–638.
- Kazmi WH, Kausz AT, Khan S, Abichandani R, Ruthazer R, Obrador GT, Pereira BJ: Anemia: an early complication of chronic renal insufficiency. Am J Kidney Dis 2001;38:803–812.
- Horl WH, Macdougall IC, Rossert J, Rutkowski B, Wauters JP, Valderrabano F: Predialysis survey on anemia management: patient referral. Am J Kidney Dis 2003;41:49–61.
- London R, Solis A, Goldberg GA, Wade S, Chan WW: Examination of resource use and clinical interventions associated with chronic kidney disease in a managed care population. J Manag Care Pharm 2003;9:248–255.
- Owen WF Jr: Patterns of care for patients with chronic kidney disease in the United States: dying for improvement. J Am Soc Nephrol 2003;14:S76–S80.
- Pisoni RL, Bragg-Gresham JL, Young EW, Akizawa T, Asano Y, Locatelli F, Bommer J, Cruz JM, Kerr PG, Mendelssohn DC, Held PJ, Port FK: Anemia management and outcomes from 12 countries in the Dialysis Outcomes and Practice Patterns Study (DOPPS). Am J Kidney Dis 2004;44:94–111.
- Valderrabano F, Horl WH, Macdougall IC, Rossert J, Rutkowski B, Wauters JP: Pre-dialysis survey on anaemia management. Nephrol Dial Transplant 2003;18:89–100.
Article / Publication Details
Received: July 17, 2008
Accepted: December 02, 2009
Published online: April 17, 2009
Issue release date: June 2009
Number of Print Pages: 9
Number of Figures: 3
Number of Tables: 3
ISSN: 1420-4096 (Print)
eISSN: 1423-0143 (Online)
For additional information: https://www.karger.com/KBR
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Get Permission