I have just re-read the ANN & there is no sensationalism to it. It’s entirely truthful & what is presented in the ADA poster, which I have observed & listened to this morning. Above are some stats from 3 years ago, and this is just Medicare funding, not Private Health cover. DKD is on the rise annually, so the figures may be much higher now as SGLT2i are now approved in the USA for DKD/CVD since this data & are expensive. A lot of research & commentary on disparities in treatment of T2D & DKD for the USA population.
The $ value may seem sensational to the ASX & new readers here, but it isn’t.
This is how big the problem of kidney disease, including DKD is in the USA, not to mention the rest of the world. 31 million people living with type 2 diabetes in the USA, of whom many will go on to develop DKD. This decline can now be halted or slowed with newer medications available, lifestyle changes & controlling things such as blood pressure which can further damage the kidneys if uncontrolled.
The biggest costs involved in treating patients with DKD are renal transplantation & Dialysis, end stage renal failure. Other savings of testing include identifying patients who will benefit from more expensive drugs (SGLT2i) to prevent renal decline, rather than just prescribe them to all patients with diabetes at any given time, because not all will need them right then & there.
This is where the prognostic value of the test will be of benefit, because the ones in the high risk category & possibly moderate, will need treatment. I think this will be attractive to payers (including Medicare & Private Insurers) as these drugs are expensive & KDIGO guidelines published & updated this year.
If you look at the trajectory of DKD & eGFR slope, it’s approximately 5 years to end stage renal failure without treatment, and unfortunately this often goes undiagnosed because it’s silent until the late stages. So you can see that break even point on cost savings at year 3 makes sense if you take into account the eGFR trajectory in an incurable chronic complication of diabetes (DKD). That is not the only one either, so preventing decline is important, as it’s all connected with cardiovascular health.
If you go back over posts (I have posted quite a lot on this over the past 3 years with links) & look at Policies put out by the USA Govt Health including the Whitehouse Bill on Kidney Disease & the Government’s own prediction & costing, it’s just astounding & on the rise.
All patients with end stage renal disease are covered in the USA by Medicare & Medicaid for the costs of treatment including dialysis. From memory, the cost of dialysis per patient is something like $100-110K per annum per patient & a lot of this is home-based with peritoneal dialysis & community nursing visits. Haemodialysis in hospital or outpatient settings, the costs would be more, plus unplanned visits to hospital & dialysis crashes. Anyway, just a small snapshot.
With COVID-19 also, this will increase as we know the virus affects diabetics in particular & damages organs, in particular the kidneys, which is a silent disease until late stage.
So if you take all of that into consideration & the costing of medications in the USA, dialysis & transplantation, it’s actually conservative as opposed to sensational in a patient population of 31 million people.
It’s just a phenomenal healthcare cost in the USA more than anything. If you know the background, the modelling is accurate & not sensational. Please DYOR though, it will open your eyes.
PromarkerD is also heavily patented across major jurisdictions in EU & Asia, where DKD is very prevalent also, more so per capita in some Asian countries.
GLTAH
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