title: Pharmaceutical cost distribution in childhood chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is associated with significant economic burdens to both patients and the healthcare system, but pharmaceutical cost analyses are uncommon despite drug therapy being a cornerstone of CKD management.
  
  
  METHODS
  This observational, retrospective review of drug cost distribution at a single tertiary care pediatric nephrology program in Canada was conducted on prevalent patients with CKD aged 1 month to 20 years, between 1 January and 31 December 2009.
  
  
  RESULTS
  The time-adjusted annual pharmaceutical cost of our cohort (n = 148) was just below US $250,000 with a cost per patient per year of $1,800. The highest costs were in the growth and nutrition category, followed by anemia, hypertension and bone metabolism. Total drug cost per patient increased as CKD stage advanced. Adherence was not demonstrated in any drug category, and the mean daily pill burden was nine (range 2-23).
  
  
  CONCLUSIONS
  This study has shown that while the annual pharmaceutical costs on a per patient basis are similar between children and adults, the cost distribution is very different. An increase in awareness of the unique needs of the pediatric population should allow for more cost-effective financial planning in pediatric CKD clinics.
authors.affiliation: Department of Pediatrics, Division of Nephrology, BC Children's Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada. jdionne@cw.bc.ca
authors.forename: Janis M
authors.initials: JM
authors.lastname: Dionne
authors.forename: Kelvin
authors.initials: K
authors.lastname: Lou
authors.forename: Lee
authors.initials: L
authors.lastname: Er
authors.forename: Kathleen
authors.initials: K
authors.lastname: Collin
authors.forename: Colin T
authors.initials: CT
authors.lastname: White
mesh_terms: D000293:Adolescent; D002170:Canada; D002648:Child; D002675:Child, Preschool; D016527:Drug Costs / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D004364:Pharmaceutical Preparations / Q000191:economics; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000191:economics*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D004364:Pharmaceutical Preparations