“The epidemiological and financial burden” of chronic kidney disease “will increase for Italy from 2021 to 2026, in the absence of early diagnosis and early access to effective therapies, by 10.8%. I believe that this is a fact that should make decision makers reflect because it is a logical consequence of the progression of the disease, damage and disability”. As Francesco Saverio Mennini, professor of Microeconomics and Health Economics, University of Rome Tor VergataPresident of the Italian Society of Health Technology Assessment (Sihta) on World Kidney Day, which is celebrated on 9 March.
Chronic kidney disease “is a very debilitating and progressive pathology – explains Mennini to time.news Salute – It is estimated that globally it has a prevalence of around 10%. It can greatly influence the quality of life especially due to the increased risk of cardiovascular events, the need for renal replacement therapy (RRT) and premature mortality. The management of the disease is therefore connected to important costs and burdens for the National Health Service”.
“Being able to understand what could happen in the future in the absence or presence of early access to therapies that are proving to be very effective – both in terms of reduction of prevalence, progression and costs – it is an important and fundamental exercise – adds the professor – to inform or decision-makers on the possible consequences of a failure to diagnose and take early charge of this disease. With this in mind, a study was carried out in 2021 (Inside Ckd, ed) involving 11 countries where, with a microsimulation model, we tried to understand the annual increases from 2021 to 2026 of patients with chronic kidney disease. We monitored age, prevalence and disease progression.”
The results show, that, “by 2026, the total number of cases of chronic renal failure will increase significantly – continues Mennini – Due to the epidemiological burden, the prevalence is around 11% and varies from 6.6% in Italy to 18.8%. Spending increases between 2.4-7.5% of national health expenditure. For Italy, it was currently around 4.6 billion, 3.2% of annual health expenditure. For all 11 countries of the model, from the point of view of the expected honor in 2026, if the current state remains unchanged, an increase in the prevalence of Rrt is expected between 2 and 4%: for Italy it goes up to 9.8% ”. This value is particularly important because already in 2021 “hemodialysis made up most of the 3 RRT modalities which impacts on costs”. Remaining on the subject of costs, the economic burden for the model foresees that “social costs will increase between 2021 and 26, for Italy, up to 11%: a very important growth. In 2026 – underlines the expert – it is expected that patients with Rrt will be between 2.3 and 7.7% of the diagnosed population and the costs will represent 19% of the total expenditure which, for Italy, is 50%. a higher cost increase than in other countries”. In general, costs in 2026 will be worth “between 3% and 9% of total health expenditure and will reach 4% in Italy, still showing very worrying growth compared to the current one”.
In summary, “the epidemiological and financial burden will increase for Italy from 2021 to 26, in the absence of early diagnosis and early access to effective therapies, by 10.8% – Mennini reiterates – I think this is a figure that must be done reflect the decision-makers because it is a logical consequence of the progression of the disease, damage and disability. Furthermore, the number of patients receiving Rrt, although lower than the pre-Rrt populations, contributes enormously to the economic burden”.
The study therefore highlights “the need, for our country, to policies to encourage early diagnosis and interventions to slow the progression of kidney disease to reduce, on the one hand, the clinical burden and improve the quality of life of citizens and, on the other, to reduce the impact of costs. The health policy measures that could and should be implemented – recalls the professor – would be a benefit for patients through diagnosis, early management, appropriateness of treatments and early access to treatments also accompanied by hospital-territory-home integration, such as envisaged by the Pnrr, to reduce the socio-economic and health impact that would occur – concludes Mennini – in the absence of these interventions”.