Healthcare expenditure and resource utilization in patients with anaemia and chronic kidney disease: a retrospective claims database analysis.
OBJECTIVE
We conducted a retrospective claims database analysis to examine the association of anaemia and anaemia management with healthcare expenditure and utilization in patients with chronic kidney disease (CKD) before the onset of dialysis.


METHODS
Claims data on patients (aged > or =15 years) with CKD were collected from the Medstat Marketscan Commercial and Medicare Databases between 2000 and 2005. Using these data, patients were evaluated for anaemia of CKD, anaemia treatment status and healthcare costs and use.


RESULTS
Of the 37,105 CKD patients, 9,807 (26%) had incident anaemia; 59% of these received at least one type of anaemia treatment, with 48% receiving an erythropoiesis-stimulating agent. The total adjusted per patient per month healthcare expenditure for all CKD patients was USD 2,749. Patients with anaemia had significantly greater overall expenditure, which was 38% higher than those without anaemia. Total expenditure was 17% higher for untreated versus treated anaemic patients, largely due to higher inpatient expenditure in the untreated cohort.


CONCLUSIONS
This analysis suggests that the presence of anaemia is associated with greater medical expenditure in patients with CKD. However, we found that anaemia management may help to lower inpatient costs associated with anaemia in the CKD population.
Wish
Jay
J
Division of Nephrology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA. jaywish@earthlink.net
Schulman
Kathy
K
Law
Amy
A
Nassar
George
G
D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000150:complications / Q000191:economics* / Q000628:therapy; D015331:Cohort Studies; D016208:Databases, Factual / Q000191:economics / Q000639:trends; D003695:Delivery of Health Care / Q000191:economics* / Q000706:statistics & numerical data*; D005260:Female; D005102:Health Expenditures / Q000639:trends; D006801:Humans; D007345:Insurance Claim Review / Q000191:economics* / Q000639:trends; D007676:Kidney Failure, Chronic / Q000150:complications / Q000191:economics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies