FP343
HEALTHCARE COSTS OF CHRONIC KIDNEY DISEASE, DIALYSIS AND KIDNEY TRANSPLANT PATIENTS COMPARED TO MATCHED CONTROLS

INTRODUCTION AND AIMS: Patients with chronic kidney disease (CKD) and renal replacement therapy (RRT) contribute significantly to healthcare expenditures. In this study we assessed the annual healthcare costs for patients with kidney disease (i.e. CKD stage 4 and 5, dialysis or kidney transplantation) in comparison with age, sex and social economic status (SES) matched controls, separately for three different age groups.

METHODS: Using Dutch health claims data we identified adult patients with CKD and RRT (i.e. dialysis or kidney transplantation). These patients were subdivided into three age categories, i.e. 19-44 years, 45-64 years and ≥ 65 years. For each of the patients groups 2 age, sex and SES matched controls were selected out of the general population. Costs data are healthcare costs per calendar-year. As the high treatment costs for RRT patients hampers the comparison with the control group, we differentiated hospital costs into costs directly and non-directly related to the CKD or RRT treatment.

RESULTS:Average annual costs: Persons with CKD in the youngest age category had 7 times higher annual costs than their matched controls (€9,416 vs. €1,425). This cost ratio decreased to 6 in the age category of 45-64 years (€12,384 vs. €2,226) and to 3 in the age category ≥ 65 years (€11,627 vs. €4,221). Young dialysis patients had 77 times higher costs compared to controls (€92,686 vs. €1,201). This cost ratio decreased to 21 (€90,808 vs. €4,292) in the oldest age category. Transplant patients aged between 19-44 years had 14 times higher costs than controls (€18,176 vs. €1,277). This cost ratio decreased to 6 (€20,743 vs. €3,774) in the age category ≥ 65 years.Hospital costs non-directly related to treatment: Costs ratios in CKD patients are practically similar across age categories. However, in dialysis patients the cost ratio decreased from 13 (€7,368 vs. €587) to 3 (€8,476 vs €2,591) and in transplant patients from 7 (€4,058 vs. €591) to 3 (€7,085 vs. €2,382) in the youngest versus the oldest age group.

CONCLUSIONS: Although annual health care costs of CKD, dialysis and transplant patients were much higher than their matched controls in all age categories, these differences in costs decreased remarkably with age. Higher costs in RRT patients are mainly driven by high treatment costs. When excluding these treatment costs, cost differences decreased but the decline with increasing age persists.