Cost-Effectiveness Assessment in Chronic Kidney Disease Management
Summary
Cost-effectiveness assessment in chronic kidney disease (CKD) management evaluates the economic value of interventions—from early detection strategies to therapeutic regimens—against health outcomes such as quality-adjusted life years (QALYs) and clinical end-points. By modelling disease progression and intervention effects over appropriate time horizons, these analyses inform resource allocation, reimbursement decisions and public health policy. Core methods include decision-analytic models such as Markov state-transition frameworks and individual-level microsimulations, which capture CKD stages, comorbid cardiovascular events and renal replacement therapies. Key outcomes encompass incremental cost-effectiveness ratios (ICERs), net monetary benefit and budget-impact estimates under willingness-to-pay thresholds. Application areas span screening protocols for albuminuria or estimated glomerular filtration rate, optimisation of renin-angiotensin system blockade and novel digital or biomarker-based detection tools. Global considerations address varying healthcare budgets, epidemiological profiles and willingness-to-pay thresholds, while practical implementation requires alignment with national guidelines and stakeholder engagement.
Research from Nature Portfolio
Recent studies have advanced non-invasive, scalable screening methodologies that underpin future economic evaluations. A novel deep learning algorithm applied to routine electrocardiograms has demonstrated robust discrimination for early-stage CKD across diverse populations, with area-under-the-curve metrics exceeding 0.75. By enabling opportunistic, low-cost case-finding in primary care and telemedicine settings, this approach promises to enhance early intervention and downstream cost savings, setting the stage for forthcoming model-based cost-effectiveness analyses that compare AI-driven screening against traditional laboratory testing.
Cost-Effectiveness Assessment in Chronic Kidney Disease Management publication trend
The graph below shows the total number of articles in cost-effectiveness assessment in chronic kidney disease management across all publications each year (not limited to Nature Index journals).
Technical terms
Incremental Cost-Effectiveness Ratio (ICER): The additional cost per additional quality-adjusted life year gained by one intervention over another.
Quality-Adjusted Life Year (QALY): A composite measure combining length of life and quality-of-life into a single metric where one QALY equates to one year in perfect health.
Markov Model: A decision-analytic framework that simulates transitions between discrete health states over time, capturing chronic disease progression and intervention effects.
Health State Utility Weight: A value between 0 and 1 representing the preference-based quality-of-life associated with a specific health state.
Albuminuria: The presence of albumin in urine, a marker of kidney damage used to stratify CKD risk and guide screening and intervention strategies.
References
- Cost-effectiveness of home-based screening of the general population for albuminuria to prevent progression of cardiovascular and kidney disease. EClinicalMedicine (2024).
- Deep learning-based electrocardiographic screening for chronic kidney disease. Communications Medicine (2023).
- Health related quality of life utility weights for economic evaluation through different stages of chronic kidney disease: a systematic literature review. Health and Quality of Life Outcomes (2020).
- The cost-effectiveness of using chronic kidney disease risk scores to screen for early-stage chronic kidney disease. BMC Nephrology (2017).
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