Estimating the financial cost of chronic kidney disease to the NHS in England

Marion Kerr, Benjamin Bray, James Medcalf, Donal J O'Donoghue, Beverley Matthews, Marion Kerr, Benjamin Bray, James Medcalf, Donal J O'Donoghue, Beverley Matthews

Abstract

Background: Chronic kidney disease (CKD) is a major challenge for health care systems around the world, and the prevalence rates appear to be increasing. We estimate the costs of CKD in a universal health care system.

Methods: Economic modelling was used to estimate the annual cost of Stages 3-5 CKD to the National Health Service (NHS) in England, including CKD-related prescribing and care, renal replacement therapy (RRT), and excess strokes, myocardial infarctions (MIs) and Methicillin-Resistant Staphylococcus Aureus (MRSA) infections in people with CKD.

Results: The cost of CKD to the English NHS in 2009-10 is estimated at £ 1.44 to £ 1.45 billion, which is ≈ 1.3% of all NHS spending in that year. More than half this sum was spent on RRT, which was provided for 2% of the CKD population. The economic model estimates that ≈ 7000 excess strokes and 12 000 excess MIs occurred in the CKD population in 2009-10, relative to an age- and gender-matched population without CKD. The cost of excess strokes and MIs is estimated at £ 174-£ 178 million.

Conclusions: The financial impact of CKD is large, with particularly high costs relating to RRT and cardiovascular complications. It is hoped that these detailed cost estimates will be useful in analysing the cost-effectiveness of treatments for CKD.

Figures

Fig. 1
Fig. 1
Distribution of costs attributable to CKD (to the nearest £million), 2009–10. Where estimates have been calculated as a range, the higher figure is shown.
Fig. 2
Fig. 2
Estimated annual cost of direct CKD care, RRT and non-RRT patients.

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