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Cost-effectiveness analysis of a randomized trial comparing care models for chronic kidney disease. Open Access


Author or creator
Hopkins, R. B.
Garg, A. X.
Levin, A.
Molzahn, A.
Rigatto, C.
Singer, J.
Soltys, G.
Soroka, S.
Parfrey, P.S.
Barrett, B.J.
Goeree, R.
Additional contributors
chronic illness
kidney diseases
preventive health services
Type of item
Journal Article (Published)
Background and objectives Potential cost and effectiveness of a nephrologist/nurse–based multifaceted intervention for stage 3 to 4 chronic kidney disease are not known. This study examines the cost-effectiveness of a chronic disease management model for chronic kidney disease. Design, setting, participants, & measurements Cost and cost-effectiveness were prospectively gathered alongside a multicenter trial. The Canadian Prevention of Renal and Cardiovascular Endpoints Trial (CanPREVENT) randomized 236 patients to receive usual care (controls) and another 238 patients to multifaceted nurse/nephrologist–supported care that targeted factors associated with development of kidney and cardiovascular disease (intervention). Cost and outcomes over 2 years were examined to determine the incremental cost-effectiveness of the intervention. Base-case analysis included disease-related costs, and sensitivity analysis included all costs. Results Consideration of all costs produced statistically significant differences. A lower number of days in hospital explained most of the cost difference. For both base-case and sensitivity analyses with all costs included, the intervention group required fewer resources and had higher quality of life. The direction of the results was unchanged to inclusion of various types of costs, consideration of payer or societal perspective, changes to the discount rate, and levels of GFR. Conclusions The nephrologist/nurse–based multifaceted intervention represents good value for money because it reduces costs without reducing quality of life for patients with chronic kidney disease.
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© 2011 American Society of Nephrology. This version of this article is open access and can be downloaded and shared. The original author(s) and source must be cited.
Citation for previous publication
Hopkins, R.B., Garg, A.X., Levin, A,, Molzahn, A., Rigatto, C., Singer, J., Soltys, G., Soroka, S., Parfrey, P.S., Barrett, B.J., Goeree, R. (2011). Cost-effectiveness analysis of a randomized trial comparing care models for chronic kidney disease [Epub ahead of print]. Clinical Journal of the American Society of Nephrology. doi: 10.2215/CJN.07180810
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