Cost-effectiveness of population-based screening for microalbuminuria in people with type 2 diabetes mellitus in India.
Int J Technol Assess Health Care
; 39(1): e66, 2023 Nov 14.
Article
em En
| MEDLINE
| ID: mdl-37960938
ABSTRACT
OBJECTIVES:
Patients with diabetes have a higher risk of developing chronic kidney disease (CKD). Early detection of CKD through microalbuminuria screening, followed by treatment, delays the progression of CKD. We evaluated the cost-effectiveness of population-based screening of microalbuminuria among normotensive type 2 diabetes mellitus patients aged >40 years compared with no screening scenario using a decision tree combined with the Markov model.METHODS:
We considered two scenarios Scenario I - dipstick microalbuminuria followed by spot-urine albumin-creatinine ratio (ACR) and serum creatinine in sequence; Scenario II - spot urine ACR plus serum creatinine. A mathematical cohort of the target population was simulated over a lifetime horizon with an annual cycle. Data for the model were obtained from secondary resources. The incremental cost-effectiveness ratios (ICERs) were estimated for screening scenarios compared to nonscreening scenario, along with sensitivity analyses.RESULTS:
The discounted ICER per quality-adjusted life years gained for annual microalbuminuria screening in the normotensive diabetic population in India were â¹ 24,114 (US$ 308) and â¹ 13,790 (US$ 176) for scenarios I and II, respectively. Annual screening by scenarios I and II resulted in a reduction of 180 and 193 end-stage renal disease (ESRD) cases per 100,000 population, respectively, resulting in a cost saving of â¹ 12.3 and 13.3 Crore spent on ESRD management over 10 years. Both scenarios were also cost-effective even at the screening frequencies of 5 and 10 yearly.CONCLUSION:
Microalbuminuria screening was cost-effective at the threshold of one-time GDP per capita in India.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Diabetes Mellitus Tipo 2
/
Insuficiência Renal Crônica
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Falência Renal Crônica
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article