Table 1.
Model Parameters for Albuminuria Screening, Treatment with Renin-angiotensin System Inhibitors, and Screening and Treatment Costs as Derived from Previous Publications
| Model Parameter | Parameter Value | Source |
|---|---|---|
| Sensitivity of screening test for moderate albuminuria | 0.73 | Sarafidis et al. [23] |
| Specificity of screening test for moderate albuminuria | 0.96 | Sarafidis et al. [23] |
| Treatment adherence of persons diagnosed with moderate albuminuria | 0.75 | Boulware et al. [14] |
| Treatment effect relative risks (multiplied by baseline rates) | ||
| Relative risk of moderate- to severe albuminuria transition for persons receiving treatment | 0.45 | Strippoli et al. [6] |
| Relative risk of mortality for persons with moderate albuminuria receiving treatment | 0.77 | Boulware et al. [14] |
| Relative risk of annual GFR decrease in persons with for persons with moderate albuminuria receiving treatment | 0.67 | Agodoa et al. [7] Ruggenenti et al. [8, 9] |
| Annual QALY decrement from CKD and related complications | ||
| Proteinuria | 0.01 | Gorodetskaya et al. [24] |
| GFR 30–59 | 0.05 | Gorodetskaya et al. [24] |
| GFR 15–29 | 0.07 | Gorodetskaya et al. [24] |
| GFR <15 | 0.20 | Gorodetskaya et al. [24] |
| Stroke, ever | 0.582 | Meenan et al. [25] |
| CA/MI, current year | 0.12 | Tsevat et al. [26] |
| CHD, ever without MI | 0.053 | Nease et al. [27] |
| Screening costs (2016 US $) | ||
| Initial visit | 88.58 | CMS [28] |
| Second visit if positive during first visit | 69.08 | CMS [28] |
| One time costs of diagnostic tests to assess for CKD if GFR <60 ml/min/1.73 m2 (2010 $) | ||
| Diabetes or hypertension | 382.41 | Boulware et al. [14, 20]; CMS [29]; AHRQ [30] |
| Neither hypertension nor diabetes: Severe albuminuria and age < 65 | 2,857.10 | Boulware et al. [14, 20]; CMS [29]; AHRQ [30] |
| Neither hypertension nor diabetes: Moderate albuminuria and age <65 | 1,401.40 | Boulware et al. [14, 20]; CMS [29]; AHRQ [30] |
| Neither hypertension nor diabetes: Age ≥65 | 964.69 | Boulware et al. [14, 20]; CMS [29]; AHRQ [30] |
| Annual follow-up costs if GFR <60 ml/min/1.73 m2 (2016 US $) | ||
| Specialist visit: | ||
| Diabetes | 94.15 | Boulware et al. [14]; CMS [28] |
| No diabetes | 85.23 | Boulware et al. [14]; CMS [28] |
| General practitioner visit | 132.88 | Boulware et al. [14]; CMS [28] |
| Annual drug therapy | ||
| ARBs (diabetes) | 527.49 | Boulware et al. [14]; Rodby et al .[31]; Lewis et al. [32]; Nakao et al. [33]; Jafar et al. [34]; Drug Topics Red Book [35]; AHRQ [36] |
| ACE inhibitors (no diabetes) | 210.03 | |
| Annual rate at which costs and QALYs are discounted (i.e. reduced) | 3% | Weinstein et al. [21] |
GFR glomerular filtration rate, ACE angiotensin converting enzyme inhibitor, AHRQ Agency for Healthcare Research and Quality, ARB angiotensin receptor blocker, CKD chronic kidney disease, CMS Centers for Medicare & Medicaid Services