title: Budget impact analysis of chronic kidney disease mass screening test in Japan.
abstract: BACKGROUND
  Our recently published cost-effectiveness study on chronic kidney disease mass screening test in Japan evaluated the use of dipstick test, serum creatinine (Cr) assay or both in specific health checkup (SHC). Mandating the use of serum Cr assay additionally, or the continuation of current policy mandating dipstick test only was found cost-effective. This study aims to examine the affordability of previously suggested reforms.
  
  
  METHODS
  Budget impact analysis was conducted assuming the economic model would be good for 15 years and applying a population projection. Costs expended by social insurers without discounting were counted as budgets.
  
  
  RESULTS
  Annual budget impacts of mass screening compared with do-nothing scenario were calculated as ¥79-¥-1,067 million for dipstick test only, ¥2,505-¥9,235 million for serum Cr assay only and ¥2,517-¥9,251 million for the use of both during a 15-year period. Annual budget impacts associated with the reforms were calculated as ¥975-¥4,129 million for mandating serum Cr assay in addition to the currently used mandatory dipstick test, and ¥963-¥4,113 million for mandating serum Cr assay only and abandoning dipstick test.
  
  
  CONCLUSIONS
  Estimated values associated with the reform from ¥963-¥4,129 million per year over 15 years are considerable amounts of money under limited resources. The most impressive finding of this study is the decreasing additional expenditures in dipstick test only scenario. This suggests that current policy which mandates dipstick test only would contain medical care expenditure.
authors: Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8577, Japan, mkondo@md.tsukuba.ac.jp.
authors: Masahide
authors: M
authors: Kondo
authors: Kunihiro
authors: K
authors: Yamagata
authors: Shu-Ling
authors: SL
authors: Hoshi
authors: Chie
authors: C
authors: Saito
authors: Koichi
authors: K
authors: Asahi
authors: Toshiki
authors: T
authors: Moriyama
authors: Kazuhiko
authors: K
authors: Tsuruya
authors: Tsuneo
authors: T
authors: Konta
authors: Shouichi
authors: S
authors: Fujimoto
authors: Ichiei
authors: I
authors: Narita
authors: Kenjiro
authors: K
authors: Kimura
authors: Kunitoshi
authors: K
authors: Iseki
authors: Tsuyoshi
authors: T
authors: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002017:Budgets / Q000639:trends*; D003362:Cost-Benefit Analysis / Q000191:economics / Q000379:methods*; D003404:Creatinine / Q000097:blood; D003955:Diagnostic Tests, Routine / Q000191:economics* / Q000379:methods; D005260:Female; D017048:Health Care Costs; D062489:Health Impact Assessment / Q000191:economics / Q000379:methods*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D018803:Models, Economic; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D003404:Creatinine