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Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD

INTRODUCTION: Chronic kidney disease (CKD) is a serious condition associated with significant morbidity and healthcare costs. Despite this, early-stage CKD is often undiagnosed, and globally there is substantial variation in the effectiveness of screening and subsequent management. Microsimulations...

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Autores principales: Tangri, Navdeep, Chadban, Steven, Cabrera, Claudia, Retat, Lise, Sánchez, Juan José García
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616410/
https://www.ncbi.nlm.nih.gov/pubmed/36307575
http://dx.doi.org/10.1007/s12325-022-02353-5
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author Tangri, Navdeep
Chadban, Steven
Cabrera, Claudia
Retat, Lise
Sánchez, Juan José García
author_facet Tangri, Navdeep
Chadban, Steven
Cabrera, Claudia
Retat, Lise
Sánchez, Juan José García
author_sort Tangri, Navdeep
collection PubMed
description INTRODUCTION: Chronic kidney disease (CKD) is a serious condition associated with significant morbidity and healthcare costs. Despite this, early-stage CKD is often undiagnosed, and globally there is substantial variation in the effectiveness of screening and subsequent management. Microsimulations can estimate future epidemiological costs, providing useful insights for clinicians, policymakers and researchers. Inside CKD is a programme designed to analyse the projected prevalence and burden of CKD for countries across the world, and to simulate hypothetical intervention strategies that can then be assessed for potential impact on health and economic outcomes at a national and a global level. METHODS: Inside CKD uses a population-based approach that creates virtual individuals for a given country, with this simulated population progressing through a microsimulation in 1-year increments. A series of data inputs derived from national statistics and key literature defined the likelihood of a change in health state for each individual. Input modules allow for the input of nationally specific demographic and CKD status (including prevalence, diagnosis rates, disease stage and likelihood of renal replacement therapy), disease progression, critical comorbidities, and mortality. Health economics are reflected in cost data and a flexible intervention module allows for the testing of hypothetical policies—such as screening strategies—that may alter disease progression and outcomes. RESULTS: Using input data from the UK as a case study and a 6-year simulation period, Inside CKD estimated a prevalence of 9.2 million individuals (both diagnosed and estimated undiagnosed) with CKD by 2027 and a 5.0% increase in costs for diagnosed CKD and renal replacement therapy. External validation and sensitivity analyses confirmed the observed trends, substantiating the robustness of the microsimulation. CONCLUSIONS: Using a microsimulation approach, Inside CKD extends the reach of current CKD policy analyses by factoring in multiple inputs that reflect national healthcare systems and enable analysis of the effect of multiple hypothetical screening scenarios on disease progression and costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-022-02353-5.
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spelling pubmed-96164102022-10-31 Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD Tangri, Navdeep Chadban, Steven Cabrera, Claudia Retat, Lise Sánchez, Juan José García Adv Ther Original Research INTRODUCTION: Chronic kidney disease (CKD) is a serious condition associated with significant morbidity and healthcare costs. Despite this, early-stage CKD is often undiagnosed, and globally there is substantial variation in the effectiveness of screening and subsequent management. Microsimulations can estimate future epidemiological costs, providing useful insights for clinicians, policymakers and researchers. Inside CKD is a programme designed to analyse the projected prevalence and burden of CKD for countries across the world, and to simulate hypothetical intervention strategies that can then be assessed for potential impact on health and economic outcomes at a national and a global level. METHODS: Inside CKD uses a population-based approach that creates virtual individuals for a given country, with this simulated population progressing through a microsimulation in 1-year increments. A series of data inputs derived from national statistics and key literature defined the likelihood of a change in health state for each individual. Input modules allow for the input of nationally specific demographic and CKD status (including prevalence, diagnosis rates, disease stage and likelihood of renal replacement therapy), disease progression, critical comorbidities, and mortality. Health economics are reflected in cost data and a flexible intervention module allows for the testing of hypothetical policies—such as screening strategies—that may alter disease progression and outcomes. RESULTS: Using input data from the UK as a case study and a 6-year simulation period, Inside CKD estimated a prevalence of 9.2 million individuals (both diagnosed and estimated undiagnosed) with CKD by 2027 and a 5.0% increase in costs for diagnosed CKD and renal replacement therapy. External validation and sensitivity analyses confirmed the observed trends, substantiating the robustness of the microsimulation. CONCLUSIONS: Using a microsimulation approach, Inside CKD extends the reach of current CKD policy analyses by factoring in multiple inputs that reflect national healthcare systems and enable analysis of the effect of multiple hypothetical screening scenarios on disease progression and costs. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12325-022-02353-5. Springer Healthcare 2022-10-28 2023 /pmc/articles/PMC9616410/ /pubmed/36307575 http://dx.doi.org/10.1007/s12325-022-02353-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Tangri, Navdeep
Chadban, Steven
Cabrera, Claudia
Retat, Lise
Sánchez, Juan José García
Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD
title Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD
title_full Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD
title_fullStr Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD
title_full_unstemmed Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD
title_short Projecting the Epidemiological and Economic Impact of Chronic Kidney Disease Using Patient-Level Microsimulation Modelling: Rationale and Methods of Inside CKD
title_sort projecting the epidemiological and economic impact of chronic kidney disease using patient-level microsimulation modelling: rationale and methods of inside ckd
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9616410/
https://www.ncbi.nlm.nih.gov/pubmed/36307575
http://dx.doi.org/10.1007/s12325-022-02353-5
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