Table 3.
Mean ratio estimates [95% Confidence Intervals] for the impact of comorbidity disease management on total, medical, and pharmacy costs in patients with chronic kidney disease
| Indicators of Good Disease Management | Both Diabetes and Hypertension (n = 120,705) | Diabetes, No Hypertension (n = 8,266) | Hypertension, No Diabetes (n = 95,705) | Neither Diabetes Nor Hypertension (n = 16,952) |
|---|---|---|---|---|
| HbA1c monitoring, patients with diabetes | ||||
| PPPM Total Costs | .830 [.815 -.844] | .736 [.689-.786] | N/A | N/A |
| PPPM Medical Costs | .755 [.740 -.771] | .661 [.613-.713] | N/A | N/A |
| PPPM Pharmacy Costs | 1.173 [1.149—1.197] | .985 [.912–1.065] | N/A | N/A |
| Glucose-lowering therapy adherence, patients with diabetes | ||||
| PPPM Total Costs | .969 [.958 -.980] | .977 [.932–1.024] | N/A | N/A |
| PPPM Medical Costs | .937 [.924 -.949] | .912 [.864-.963] | N/A | N/A |
| PPPM Pharmacy Costs | 1.037 [1.022 -1.051] | 1.078 [1.020–1.140] | N/A | N/A |
| CVD therapy adherence, patients with hypertension | ||||
| PPPM Total Costs | 1.007 [.993–1.021] | N/A | .975 [.960-.991] | N/A |
| PPPM Medical Costs | .948 [.933-.963] | N/A | .954 [.938-.970] | N/A |
| PPPM Pharmacy Costs | 1.222 [1.202 -1.242] | N/A | 1.074 [1.053–1.096] | N/A |
| ACEi/ARB adherence, patients with proteinuria | ||||
| Total Costs | .994 [.966–1.021] | 1.172 [.996–1.379] | .998 [.945–1.054] | .900 [.705–1.148] |
| PPPM Medical Costs | .987 [.956–1.020] | 1.184 [.983–1.425] | 1.010 [.953–1.071] | .873 [.676–1.128] |
| PPPM Pharmacy Costs | 1.011 [.978–1.045] | .994 [.820–1.205] | .959 [.896–1.026] | 1.227 [.892–1.687] |
| ≥ 3 nephrologist visits, patients at high renal risk | ||||
| PPPM Total Costs | .896 [.863-.930] | 1.216 [.855–1.729] | .855 [.807-.907 | .548 [.400 -.750] |
| PPPM Medical Costs | .843 [.807-.880] | 1.096 [.734–1.638] | .804 [.755-.855] | .437 [.314—.608] |
| PPPM Pharmacy Costs | 1.076 [1.029–1.126] | 1.580 [1.043–2.393] | 1.154 [1.074–1.240] | .962 [.634 -1.460] |
| ≥ 2 PCP visits, patients at low renal risk | ||||
| PPPM Total Costs | .954 [.938—.971] | .923 [.864—.987] | .917 [.897-.937] | .808 [.774-.843] |
| PPPM Medical Costs | .941 [.922—.960] | .930 [.861—1.004] | .904 [.883-.925] | .828 [.792-.866] |
| PPPM Pharmacy Costs | 1.016 [.995—1.037] | .939 [.869—1.015] | .969 [.943-.996] | .727 [.687-.770] |
ACEi/ARB Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, CVD Cardiovascular disease, HbA1C Hemoglobin A1C, N/A Not applicable, PPPM Per person per month, PCP Primary care provider. Estimates were adjusted for patient demographic characteristics, comorbidities, and CKD stage. Bolding denotes statistical significance at the 0.05 level