Abstract / Summary
Abstract Background Immunoglobulin A nephropathy (IgAN) is a progressive kidney condition in which abnormal immune complexes form in the circulation and are deposited in the glomeruli of kidneys. For decades, the mainstay of management has been with conservative care. There are many novel therapies in various stages of clinical trials. This potentially has the scope to change the landscape of treatment for IgAN in the coming years. There has been little reported on the healthcare associated costs for patients with IgAN, but this is likely to become increasingly important as novel therapies become available for use clinically. Methods We identified 110 patients diagnosed with IgAN at Salford Royal Hospital, UK, between January 2015 and December 2019 from our biopsy database and electronic record. Data was collected for age, sex, ethnicity, progression to need for kidney replacement therapy (KRT) and mortality. We used the NHS National Cost Collection for the relevant years to determine hospital admission costs, and the costs for various forms of KRT by year. It was not possible to include the costs for low cost items such as medications. The total cohort was divided into subgroups by age, sex, ethnicity and mortality status. Results The mean total cost per patient over the study period was £23,333. Of the total cost, the majority (69%) was due to KRT. The mean annual cost increased across the 6 age groups up to a peak of £47,929 for those aged ≥ 66 years. There were similar costs amongst males and females. There were greater mean annual and total costs amongst those patients who died during the study period compared to those who were still alive. Conclusions We report here a comprehensive study of healthcare associated costs in a large cohort of patients with IgAN. This is important and relevant in an era of novel therapies for use in IgAN. Commissioners and clinicians are likely to need to make decisions about treatment based on the relative cost effectiveness of these treatments. With knowledge of existing healthcare associated costs of IgAN including KRT, the cost implications of these decisions can be more readily determined.