The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease.
Although major guidelines uniformly recommend iron supplementation and erythropoietin stimulating agents (ESAs) for managing chronic anemia in persons with chronic kidney disease (CKD), there are differences in the recommended hemoglobin (Hb) treatment target and no guidelines consider the costs or...
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doaj-147e64808fc14b04a9339fbc3a703d902020-11-25T01:31:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01117e015732310.1371/journal.pone.0157323The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease.Benjamin O YarnoffThomas J HoergerSiobhan A SimpsonMeda E PavkovNilka R BurrowsSundar S ShresthaDesmond E WilliamsXiaohui ZhuoAlthough major guidelines uniformly recommend iron supplementation and erythropoietin stimulating agents (ESAs) for managing chronic anemia in persons with chronic kidney disease (CKD), there are differences in the recommended hemoglobin (Hb) treatment target and no guidelines consider the costs or cost-effectiveness of treatment. In this study, we explored the most cost-effective Hb target for anemia treatment in persons with CKD stages 3-4.The CKD Health Policy Model was populated with a synthetic cohort of persons over age 30 with prevalent CKD stages 3-4 (i.e., not on dialysis) and anemia created from the 1999-2010 National Health and Nutrition Examination Survey. Incremental cost-effectiveness ratios (ICERs), computed as incremental cost divided by incremental quality adjusted life years (QALYs), were assessed for Hb targets of 10 g/dl to 13 g/dl at 0.5 g/dl increments. Targeting a Hb of 10 g/dl resulted in an ICER of $32,111 compared with no treatment and targeting a Hb of 10.5 g/dl resulted in an ICER of $32,475 compared with a Hb target of 10 g/dl. QALYs increased to 4.63 for a Hb target of 10 g/dl and to 4.75 for a target of 10.5 g/dl or 11 g/dl. Any treatment target above 11 g/dl increased medical costs and decreased QALYs.In persons over age 30 with CKD stages 3-4, anemia treatment is most cost-effective when targeting a Hb level of 10.5 g/dl. This study provides important information for framing guidelines related to treatment of anemia in persons with CKD.http://europepmc.org/articles/PMC4942058?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Benjamin O Yarnoff Thomas J Hoerger Siobhan A Simpson Meda E Pavkov Nilka R Burrows Sundar S Shrestha Desmond E Williams Xiaohui Zhuo |
spellingShingle |
Benjamin O Yarnoff Thomas J Hoerger Siobhan A Simpson Meda E Pavkov Nilka R Burrows Sundar S Shrestha Desmond E Williams Xiaohui Zhuo The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease. PLoS ONE |
author_facet |
Benjamin O Yarnoff Thomas J Hoerger Siobhan A Simpson Meda E Pavkov Nilka R Burrows Sundar S Shrestha Desmond E Williams Xiaohui Zhuo |
author_sort |
Benjamin O Yarnoff |
title |
The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease. |
title_short |
The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease. |
title_full |
The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease. |
title_fullStr |
The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease. |
title_full_unstemmed |
The Cost-Effectiveness of Anemia Treatment for Persons with Chronic Kidney Disease. |
title_sort |
cost-effectiveness of anemia treatment for persons with chronic kidney disease. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2016-01-01 |
description |
Although major guidelines uniformly recommend iron supplementation and erythropoietin stimulating agents (ESAs) for managing chronic anemia in persons with chronic kidney disease (CKD), there are differences in the recommended hemoglobin (Hb) treatment target and no guidelines consider the costs or cost-effectiveness of treatment. In this study, we explored the most cost-effective Hb target for anemia treatment in persons with CKD stages 3-4.The CKD Health Policy Model was populated with a synthetic cohort of persons over age 30 with prevalent CKD stages 3-4 (i.e., not on dialysis) and anemia created from the 1999-2010 National Health and Nutrition Examination Survey. Incremental cost-effectiveness ratios (ICERs), computed as incremental cost divided by incremental quality adjusted life years (QALYs), were assessed for Hb targets of 10 g/dl to 13 g/dl at 0.5 g/dl increments. Targeting a Hb of 10 g/dl resulted in an ICER of $32,111 compared with no treatment and targeting a Hb of 10.5 g/dl resulted in an ICER of $32,475 compared with a Hb target of 10 g/dl. QALYs increased to 4.63 for a Hb target of 10 g/dl and to 4.75 for a target of 10.5 g/dl or 11 g/dl. Any treatment target above 11 g/dl increased medical costs and decreased QALYs.In persons over age 30 with CKD stages 3-4, anemia treatment is most cost-effective when targeting a Hb level of 10.5 g/dl. This study provides important information for framing guidelines related to treatment of anemia in persons with CKD. |
url |
http://europepmc.org/articles/PMC4942058?pdf=render |
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