Previous analyzes of the Towards Home-based Albuminuria Screening (THOMAS) study already showed that screening for albuminuria from home to early detect chronic kidney damage (CNS) is effective. The Dutch researchers now show that the method also appears to be cost-effective.
CNS is often discovered late, leading to poorer health outcomes and higher healthcare costs. Screening for albuminuria from home with a urine sample (UCD) can detect kidney damage early, so that treatment can be started in time to prevent progressive loss of kidney function and cardiovascular disease. The researchers of the THOMAS study used a prospective implementation study to find out whether this method of screening is also cost-effective.
Pouwels and colleagues developed a simulation model to compare screening from home with the UCD method with standard care (without home screening) in people from the general population (45-80 years) who participated in the THOMAS study. They assessed cost-effectiveness from the perspective of the Dutch healthcare system with a lifetime time horizon and included the costs of the screening process and the benefits of the prevention of CNS progression and cardiovascular events.
The probabilistic analyzes showed that screening led to a relative decrease in dialysis (10.7%), kidney transplantation (11.1%), non-fatal myocardial infarction (5.1%), non-fatal stroke (4.1%) and fatal cardiovascular events (1.6%) compared to standard care. Screening was associated with €1,607 in incremental costs and 0.17 quality adjusted life years (QALYs), resulting in a cost-effectiveness ratio (IKER) of €9,225/QALY. In the Netherlands, a preventive screening method is considered cost-effective up to a ‘willingness-to-pay’ limit of € 20,000/QALY. According to the researchers’ calculations, the chance that screening for albuminuria to prevent CNS and cardiovascular events is cost-effective by that measure was 95%.
Source:
Pouwels XGLV, Mil D van, Kieneker LM, et al. Cost-effectiveness of home-based screening of the general population for albuminuria to prevent progression of cardiovascular and kidney disease. eClinicalMedicine 2024;68:102414.
