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

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.