The cost-effectiveness of primary screening for chronic kidney disease in Manitoba’s rural and remote First Nations
Chronic Kidney Disease (CKD) is a risk factor for cardiovascular disease, early mortality, and kidney failure. There is a substantial burden of CKD in Manitoba’s rural and remote First Nations. Early detection and treatment of CKD in this population may be cost-effective. We constructed a Markov model comparing screening for CKD, by both estimated glomerular filtration rate and albuminuria, to usual care using the perspective of the health care payer. Patients were classified into initial risk groups based on results from the First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis initiative. Screening in Manitoba’s rural and remote First Nations was associated with a $33,500/QALY incremental cost-effectiveness ratio in comparison to usual care. Restricting to communities accessible primarily by air travel, this ratio fell to $16,180/QALY. In conclusion, at a willingness-to-pay threshold of $50,000/QALY, screening for CKD in Manitoba’s rural and remote First Nations is likely cost-effective.
Kidney, Cost-Effectiveness, Screening, Cost-Utility, Dialysis, Renal, Cost, Model