Cost-effectiveness of chronic kidney disease mass screening test in Japan.
Clin Exp Nephrol
; 16(2): 279-91, 2012 Apr.
Article
en En
| MEDLINE
| ID: mdl-22167460
ABSTRACT
BACKGROUND:
Chronic kidney disease (CKD) is a significant public health problem. Strategy for its early detection is still controversial. This study aims to assess the cost-effectiveness of population strategy, i.e. mass screening, and Japan's health checkup reform.METHODS:
Cost-effectiveness analysis was carried out to compare test modalities in the context of reforming Japan's mandatory annual health checkup for adults. A decision tree and Markov model with societal perspective were constructed to compare dipstick test to check proteinuria only, serum creatinine (Cr) assay only, or both.RESULTS:
Incremental cost-effectiveness ratios (ICERs) of mass screening compared with do-nothing were calculated as ¥1,139,399/QALY (US $12,660/QALY) for dipstick test only, ¥8,122,492/QALY (US $90,250/QALY) for serum Cr assay only and ¥8,235,431/QALY (US $91,505/QALY) for both. ICERs associated with the reform were calculated as ¥9,325,663/QALY (US $103,618/QALY) for mandating serum Cr assay in addition to the currently used mandatory dipstick test, and ¥9,001,414/QALY (US $100,016/QALY) for mandating serum Cr assay and applying dipstick test at discretion.CONCLUSIONS:
Taking a threshold to judge cost-effectiveness according to World Health Organization's recommendation, i.e. three times gross domestic product per capita of ¥11.5 million/QALY (US $128 thousand/QALY), a policy that mandates serum Cr assay is cost-effective. The choice of continuing the current policy which mandates dipstick test only is also cost-effective. Our results suggest that a population strategy for CKD detection such as mass screening using dipstick test and/or serum Cr assay can be justified as an efficient use of health care resources in a population with high prevalence of the disease such as in Japan and Asian countries.
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tamizaje Masivo
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Creatinina
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Insuficiencia Renal Crónica
Tipo de estudio:
Diagnostic_studies
/
Health_economic_evaluation
/
Prognostic_studies
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Risk_factors_studies
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Screening_studies
Límite:
Adult
/
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
Clin Exp Nephrol
Asunto de la revista:
NEFROLOGIA
Año:
2012
Tipo del documento:
Article
País de afiliación:
Japón