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Lifetime benefits of early detection and treatment of diabetic kidney disease.

Authors :: Thornton Snider J
Sullivan J
van Eijndhoven E
Hansen MK
Bellosillo N
Neslusan C
O'Brien E
Riley R
Seabury S
Kasiske BL
Source :: PloS one [PLoS One] 2019 May 31; Vol. 14 (5), pp. e0217487. Date of Electronic Publication: 2019 May 31 (Print Publication: 2019).
Publication Year :: 2019
Abstract: Objectives: Diabetic kidney disease (DKD) is a frequent complication of diabetes with potentially devastating consequences that may be prevented or delayed. This study aimed to estimate the health and economic benefit of earlier diagnosis and treatment of DKD.<br />Methods: Life expectancy and medical spending for people with diabetes were modeled using The Health Economics Medical Innovation Simulation (THEMIS). THEMIS uses data from the Health and Retirement Study to model cohorts of individuals over age 50 to project population-level lifetime health and economic outcomes. DKD status was imputed based on diagnoses and laboratory values in the National Health and Nutrition Examination Survey. We simulated the implementation of a new biomarker identifying people with diabetes at an elevated risk of DKD and DKD patients at risk of rapid progression.<br />Results: Compared to baseline, the prevalence of DKD declined 5.1% with a novel prognostic biomarker test, while the prevalence of diabetes with stage 5 chronic kidney disease declined 3.0%. Consequently, people with diabetes gained 0.2 years in life expectancy, while per-capita annual medical spending fell by 0.3%. The estimated cost was $12,796 per life-year gained and $25,842 per quality-adjusted life-year.<br />Conclusions: A biomarker test that allows earlier treatment reduces DKD prevalence and slows DKD progression, thereby increasing life expectancy among people with diabetes while raising healthcare spending by less than one percent.<br />Competing Interests: Dr. Snider, Mr. Sullivan, and Ms. van Eijndhoven are employees of PHE, which provides consulting services to life science firms. Dr. Snider holds equity in PHE. Dr. Kasiske and Dr. Seabury are consultants for PHE. Mr. Riley, Dr. Hansen, Dr. Neslusan, Dr. O’Brien, and Dr. Bellosillo are employees of Janssen, which provided financial support to PHE for this study. Janssen's website can be found here: https://www.janssen.com/us/. Janssen played a role in the study design, decision to publish, and review of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.