The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetes

Abstract

ABSTRACT Aims/Introduction This analysis seeks to evaluate the cost‐effectiveness of urine albumin‐to‐creatinine ratio testing compared with urine protein‐creatinine ratio testing and no urine testing for the identification of kidney damage in individuals with type 2 diabetes who have, or are at risk of, chronic kidney disease in Japan. Materials and Methods A health‐economic model estimated the clinical and economic consequences of different tests to evaluate kidney damage in line with Japanese guidelines, taking a Japanese healthcare perspective. Differences in the diagnostic performance of tests were considered by the integration of real‐world Japanese data. Outcomes were considered over a lifetime horizon, and included costs, prevented dialyses, life years gained, quality‐adjusted life years, and incremental cost‐effectiveness ratios. Results Repeated urine albumin‐to‐creatinine ratio testing was found to be cost‐effective compared with both urine protein‐creatinine ratio testing and no urine testing, yielding incremental cost‐effectiveness ratios of ¥2,652,693 and ¥2,460,453, respectively. Conclusions Repeated urine albumin‐to‐creatinine ratio testing is cost‐effective compared with urine protein‐creatinine ratio testing and no urine testing in Japanese individuals with type 2 diabetes, supporting existing clinical evidence that albumin‐to‐creatinine ratio testing should be used more widely, particularly compared with other urine tests such as urine protein‐creatinine ratio testing.

Keywords

• Albuminuria
• Cost‐effectiveness analysis
• Diabetes mellitus