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

ABSTRACT 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 ris...

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Main Authors: Koichi Asahi, Tsuneo Konta, Kouichi Tamura, Fumitaka Tanaka, Akira Fukui, Yusuke Nakamura, Junichi Hirose, Kenichi Ohara, Yoko Shijoh, Matthew Carter, Kimberley Meredith, James Harris, Örjan Åkerborg, Naoki Kashihara, Takashi Yokoo
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Journal of Diabetes Investigation
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Online Access:https://doi.org/10.1111/jdi.14293
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author Koichi Asahi
Tsuneo Konta
Kouichi Tamura
Fumitaka Tanaka
Akira Fukui
Yusuke Nakamura
Junichi Hirose
Kenichi Ohara
Yoko Shijoh
Matthew Carter
Kimberley Meredith
James Harris
Örjan Åkerborg
Naoki Kashihara
Takashi Yokoo
author_facet Koichi Asahi
Tsuneo Konta
Kouichi Tamura
Fumitaka Tanaka
Akira Fukui
Yusuke Nakamura
Junichi Hirose
Kenichi Ohara
Yoko Shijoh
Matthew Carter
Kimberley Meredith
James Harris
Örjan Åkerborg
Naoki Kashihara
Takashi Yokoo
author_sort Koichi Asahi
collection DOAJ
description ABSTRACT 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.
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spelling doaj-art-1364e07d45ad4b57be9fc72145d4e4fd2025-08-20T01:47:43ZengWileyJournal of Diabetes Investigation2040-11162040-11242025-01-0116110811910.1111/jdi.14293The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetesKoichi Asahi0Tsuneo Konta1Kouichi Tamura2Fumitaka Tanaka3Akira Fukui4Yusuke Nakamura5Junichi Hirose6Kenichi Ohara7Yoko Shijoh8Matthew Carter9Kimberley Meredith10James Harris11Örjan Åkerborg12Naoki Kashihara13Takashi Yokoo14Division of Nephrology and Hypertension, Department of Internal Medicine Iwate Medical University School of Medicine Morioka Iwate JapanDepartment of Public Health and Hygiene Yamagata University Graduate School of Medicine Yamagata Yamagata JapanDepartment of Medical Science and Cardiorenal Medicine Yokohama City University Graduate School of Medicine Yokohama Kanagawa JapanDivision of Nephrology and Hypertension, Department of Internal Medicine Iwate Medical University School of Medicine Morioka Iwate JapanDivision of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine Minato Tokyo JapanBayer Yakuhin Ltd Osaka Osaka JapanBayer Yakuhin Ltd Osaka Osaka JapanBayer Yakuhin Ltd Osaka Osaka JapanBayer Yakuhin Ltd Osaka Osaka JapanWickenstones Ltd Carlow IrelandWickenstones Ltd Carlow IrelandWickenstones Ltd Carlow IrelandWickenstones Ltd Carlow IrelandKawasaki Geriatric Medical Center Okayama Okayama JapanDivision of Nephrology and Hypertension, Department of Internal Medicine The Jikei University School of Medicine Minato Tokyo JapanABSTRACT 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.https://doi.org/10.1111/jdi.14293AlbuminuriaCost‐effectiveness analysisDiabetes mellitus
spellingShingle Koichi Asahi
Tsuneo Konta
Kouichi Tamura
Fumitaka Tanaka
Akira Fukui
Yusuke Nakamura
Junichi Hirose
Kenichi Ohara
Yoko Shijoh
Matthew Carter
Kimberley Meredith
James Harris
Örjan Åkerborg
Naoki Kashihara
Takashi Yokoo
The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetes
Journal of Diabetes Investigation
Albuminuria
Cost‐effectiveness analysis
Diabetes mellitus
title The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetes
title_full The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetes
title_fullStr The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetes
title_full_unstemmed The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetes
title_short The health‐economic impact of urine albumin‐to‐creatinine ratio testing for chronic kidney disease in Japanese patients with type 2 diabetes
title_sort health economic impact of urine albumin to creatinine ratio testing for chronic kidney disease in japanese patients with type 2 diabetes
topic Albuminuria
Cost‐effectiveness analysis
Diabetes mellitus
url https://doi.org/10.1111/jdi.14293
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