title: A simulation model to estimate cost-offsets for a disease-management program for chronic kidney disease.
abstract: OBJECTIVE
  The aim of this paper is to develop a simulation model that analyzes cost-offsets of a hypothetical disease management program (DMP) for patients with chronic kidney disease (CKD) in Germany compared to no such program.
  
  
  METHODS
  A lifetime Markov model with simulated 65-year-old patients with CKD was developed using published data on costs and health status and simulating the progression to end-stage renal disease (ESRD), cardiovascular disease and death. A statutory health insurance perspective was adopted.
  
  
  RESULTS
  This modeling study shows considerable potential for cost-offsets from a DMP for patients with CKD. The potential for cost-offsets increases with relative risk reduction by the DMP and baseline glomerular filtration rate. Results are most sensitive to the cost of dialysis treatment.
  
  
  CONCLUSIONS
  This paper presents a general 'prototype' simulation model for the prevention of ESRD. The model allows for further modification and adaptation in future applications.
authors.affiliation: Frankfurt School of Finance and Management, Frankfurt, Germany.
authors.forename: Afschin
authors.initials: A
authors.lastname: Gandjour
authors.forename: Ulrich
authors.initials: U
authors.lastname: Tschulena
authors.forename: Sonja
authors.initials: S
authors.lastname: Steppan
authors.forename: Emanuele
authors.initials: E
authors.lastname: Gatti
mesh_terms: D000368:Aged; D018450:Disease Progression; D005858:Germany; D005919:Glomerular Filtration Rate; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D007676:Kidney Failure, Chronic / Q000191:economics / Q000517:prevention & control; D008390:Markov Chains; D018803:Models, Economic; D006435:Renal Dialysis / Q000191:economics; D051436:Renal Insufficiency, Chronic / Q000191:economics / Q000503:physiopathology / Q000628:therapy*
keywords: chronic kidney disease; disease management; simulation model