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Publication type: Article in scientific journal
Type of review: Peer review (publication)
Title: Health economic modelling of the cost-effectiveness of microalbuminuria screening in Switzerland
Authors: Kessler, Reto
Keusch, Gérard
Szucs, Thomas
Wittenborn, John
Hoerger, Thomas
Brügger, Urs
Wieser, Simon
DOI: 10.21256/zhaw-4765
Published in: Swiss Medical Weekly
Volume(Issue): 142
Page(s): 1
Pages to: 13
Issue Date: 2012
Publisher / Ed. Institution: EMH Schweizerischer Ärzteverlag
ISSN: 1424-7860
Language: English
Subjects: Albuminuria; Cost-benefit analysis; Disease progression; Follow-up study; Mass screening; Prevalence; Retrospective study; Economic models
Subject (DDC): 362.1041: Health economics
Abstract: Principles: Current evidence indicates that chronic kidney disease (CKD) can be detected by simple laboratory tests. This study aimed to evaluate the cost-effectiveness of microalbuminuria screening and subsequent treatment in different populations. Methods: Cost-effectiveness of microalbuminuria screening in a cohort of simulated subjects aged ≥50 years was assessed using a validated microsimulation model. Microalbuminuria screening was simulated for 1-, 2-, 5- or 10-year intervals and for 3 groups: diabetes (DM), hypertension but no diabetes (HTN), and no diabetes or hypertension. Positive microalbuminuria screening was followed by treatment with angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs). The model outcomes evaluate costs from a health care system perspective. Results: Screening of risk groups is cost-effective at a 2-year interval for the DM group with an incremental cost-effectiveness ratio (ICER) of 54,000 CHF/ Quality Adjusted-Life-Years (QALY) and at a 5-year interval for the HTN group with an ICER of 33,000CHF/QALY . Screening of the remaining population is cost-effective at a 10-year interval with an ICER of 34,000 CHF/QALY . The ICER improves with longer screening intervals for all groups. A probabilistic sensitivity analysis (PSA) confirmed 2-year, 5-year and 10-year intervals as the most cost-effective for the DM group, the HTN group and the remaining population respectively. Conclusions: Microalbuminuria screening can be considered cost-effective starting at the age of 50 years at biannual intervals for subjects with diabetes, at 5-year intervals for subjects with hypertension and at10-year intervals for the remaining population. Our results indicate that early detection and treatment of CKD might lead to optimised patient care, and offer guidance for future implementation of CKD screening programmes.
Fulltext version: Published version
License (according to publishing contract): CC BY-NC-ND 4.0: Attribution - Non commercial - No derivatives 4.0 International
Departement: School of Management and Law
Organisational Unit: Winterthur Institute of Health Economics (WIG)
Appears in collections:Publikationen School of Management and Law

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