Русский
The costs of chronic kidney disease in Russian Federation
DOI: https://dx.doi.org/10.18565/nephrology.2021.4.30-38
O.N. Kotenko, V.V. Omelyanovskiy, V.I. Ignatyeva, Е.Е. Yagnenkova, E.I. Rumyantseva
1) Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital №52 of the Moscow Healthcare Department, Moscow, Russia; 2) Center for Expertise and Quality Control of Medical Care, Moscow, Russia; 3) Russian Medical Academy of Continuing Professional Education, Moscow, Russia; 4) Financial Research Institute, Moscow, Russia; 5) ANO “National Center for Health Technology Assessment”, Moscow, Russia; 6) Sechenov First Moscow State Medical University, Moscow, Russia
Objective. To assess medical costs attributable to CKD from the position of public health payer in Russian Federation.
Methods. We modelled the CKD costs depending on disease stage. The number of medical services provided and administered drugs were defined based on clinical guidelines and published Russian and international research. The price for medical services was based on public health insurance tariffs and for drugs – on governmental procurement. The total amount and structure of costs for the whole population were evaluated based on the prevalence according to the number of diagnoses registered during outpatient medical encounters and expected prevalence according to the epidemiologic research.
Findings. The annual medical cost per patient covered by the public health payer varied from 0,87 thousand RUR at stage 1 to 20,97 thousand RUR at stage 4, reaching 945,01 thousand RUR at stage 5. The total costs for the whole population were estimated between 111,9 – 200 bln RUR, depending on the chosen approach to estimate the prevalence, with the number of patients at stage 5 and renal replacement therapy being the main cost drivers.
Conclusion. The average annual costs per patient with CKD stage 5 are above 950 thousand RUR, surpassing the costs of stages 1 – 4 more than 20 times. Thus, it appears highly probable that costs of interventions aimed at controlling and slowing down the CKD progression would be compensated by decreasing the late-stage costs.
About the Autors
Oleg N. Kotenko – PhD, Chief External Expert in Nephrology of the Moscow Healthcare Department, Head of the Moscow Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology, City Clinical Hospital №52 of the Moscow Healthcare Department, Moscow, Russia, e-mail: olkotenko@yandex.ru. ORCID ID:0000-0003-4991-4113
Vitaliy V. Omelyanovskiy – Dr. Med. Sc., Professor, Director General, Center for Expertise and Quality Control of Medical Care; Head of Center for Health Finance, Financial Research Institute; Chief of Chair for Economics, Management and Assesment of Healthcare Technologies, Russian Medical Academy of Continuing Professional Education, Moscow, Russia, e-mail office@rosmedex.ru. ORCID ID: 0000-0003-1581-0703
Victoria I. Ignatyeva – MPH, PhD, Head of the Department of Evidence-Based Medicine, Biostatistics and Mathematical Modeling, The National Center for Health Technology Assessment; Assistant professor of department of health economics, management and technology assessment Russian Medical Academy of Continuous Professional Education, Moscow, Russia, e-mail ignateva@hta-rus.ru. ORCID ID: 0000-0001-6789-9514.
Ekaterina E. Yagnenkova – researcher, Department of Clinical and Economic Analysis, Biostatistics and Mathematical Modeling, The National Center for Health Technology Assessment. ORCID ID: 0000-0002-3553-1835.
Elizaveta I. Rumyantseva – PhD student, Institute of Leadership and Health Management, Sechenov First Moscow State Medical University, Moscow, Russia, e-mail lizarum17@yandex.ru. ORCID ID: 0000-0002-4935-4139
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