Literature DB >> 31234668

Economic and clinical benefits of early identification of acute kidney injury using a urinary biomarker.

Mauricio A Berdugo1, Noam Y Kirson2, Louise Zimmer1, Hadi Beyhaghi1, Seth Toback1, Lauren M Scarpati2, Michael N Stone2, Ross Dember2, Joshua Tseng-Tham2, Jody Wen2, Mark Miller3.   

Abstract

Purpose: To evaluate the budget impact of adding a diagnostic test of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor binding protein 7 ([TIMP-2]·[IGFBP7]), which identifies patients at risk of moderate-to-severe acute kidney injury (AKI), to the current standard of care (SOC) in a hospital setting.Materials and methods: A budget impact model (2017 USD) was developed from the perspective of a hypothetical US hospital system serving 10,000 inpatients annually. The model estimated the impact of assessing the risk of AKI using SOC vs a combination of SOC and the US Food and Drug Administration-approved assay [TIMP-2]·[IGFBP7] over a 1-year period. Potential cost implications were assessed using estimates for payer mix among patients, diagnostic efficacy, and patient healthcare resource utilization. The model also considered provider adoption rates and the estimated costs of [TIMP-2]·[IGFBP7].
Results: Compared to SOC alone, adding [TIMP-2]·[IGFBP7] to SOC was associated with a $1,855 reduction in uncompensated care per patient tested, which, after accounting for the additional costs of the test ($277), resulted in net savings of $1,578 per patient tested. The findings were robust to input parameter variations, as demonstrated by deterministic and probabilistic sensitivity analyses. In the probabilistic sensitivity analyses, net cost savings to the hospital ranged from $50,308-$3,971,514, or $101-$7,943 per tested patient (mean = $1,710; 95% confidence interval = $1,691-$1,729).Conclusions: The introduction of [TIMP-2]·[IGFBP7] as a novel tool in the identification of AKI risk may result in considerable cost savings from a hospital perspective under this model's base-case assumptions. Further prospective studies are needed to confirm these findings in a real-world setting.Key points for decision makersAn economic model was constructed to determine the budget impact of adding a diagnostic test ([TIMP-2]·[IGFBP7]), which identifies patients at risk of moderate-to-severe acute kidney injury, to the current standard of care (SOC) in a hospital setting.According to the present model, the use of [TIMP-2]·[IGFBP7] to identify acute kidney injury risk may reduce costs for hospitals by ∼$1,578 per patient tested.

Entities:  

Keywords:  Acute kidney injury; I11; I19; NephroCheck; [TIMP-2]·[IGFBP7]; biomarker-based testing

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Substances:

Year:  2019        PMID: 31234668     DOI: 10.1080/13696998.2019.1636053

Source DB:  PubMed          Journal:  J Med Econ        ISSN: 1369-6998            Impact factor:   2.448


  3 in total

1.  Advances in laboratory detection of acute kidney injury.

Authors:  Faeq Husain-Syed; Thiago Reis; Kianoush Kashani; Claudio Ronco
Journal:  Pract Lab Med       Date:  2022-06-02

2.  Randomized Controlled Trial Evidence of Cost-Effectiveness of a Multifaceted AKI Intervention Approach.

Authors:  Nicholas M Selby; Luís Korrodi-Gregório; Anna Casula; Nitin V Kolhe; Daniel Ribes Arbonés; Katelyn D Bukieda; Deepak Sahu; Chris Rao; Giacomo Basadonna
Journal:  Kidney Int Rep       Date:  2020-12-16

3.  Clinical Implementation of NGAL Testing to Improve Diagnostic Assessment of AKI Episodes in a Canadian Center.

Authors:  Jean-Maxime Côté; Roxanne Authier; Isabelle Ethier; Jean-François Cailhier; William Beaubien-Souligny; Patrick T Murray; Pierre-Olivier Hétu; Marie-Claire Bélanger
Journal:  Can J Kidney Health Dis       Date:  2022-08-17
  3 in total

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