The social cost of chronic kidney disease in ItalyReport as inadecuate

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The European Journal of Health Economics

pp 1–12

First Online: 03 October 2016Received: 10 November 2015Accepted: 13 September 2016DOI: 10.1007-s10198-016-0830-1

Cite this article as: Turchetti, G., Bellelli, S., Amato, M. et al. Eur J Health Econ 2016. doi:10.1007-s10198-016-0830-1


This study aims to estimate the mean annual social cost per patient with chronic kidney disease CKD by stages 4 and 5 pre-dialyses and cost components in Italy. The multicenter cross-sectional study included all adult outpatients in charge of the 14 main Nephrology Centers of Tuscany Region during 7 weeks from 2012 to 2013. Direct medical costs have been estimated using tariffs for laboratory tests, diagnostic exams, visits, hospitalization and prices for drugs. Non-medical costs included expenses of low-protein special foods, travel, and formal and informal care. Patients’ and caregivers’ losses of productivity have been estimated as indirect costs using the human capital approach. Costs have been expressed in Euros 2016. Totals of 279 patients in stage 4 and 205 patients in stage 5 have been enrolled. The estimated mean annual social cost of a patient with CKD were €7422 ±€6255 for stage 4 and €8971 ±€6503 for stage 5 p < 0.05. Direct medical costs were higher in stage 5 as compared to stage 4; direct non-medical costs and indirect costs accounted, respectively, for 41 and 5 % of the total social cost of CKD stage 4 and for 33 and 9 % of CKD stage 5. In Italy, the overall annual social cost of CKD was €1,809,552,398 representing 0.11 % of the Gross Domestic Product. Direct non-medical costs and indirect costs were weighted on the social cost of CKD almost as much as the direct medical cost. Patients, their families and the productivity system sustain the burden of the disease almost as much as the healthcare system.

KeywordsCost of illness Chronic kidney disease CKD stages 4 and 5 Direct costs Indirect costs Italy Members of -the Tuscany CKD study group- have been listed in the Acknowledgments.

Electronic supplementary materialThe online version of this article doi:10.1007-s10198-016-0830-1 contains supplementary material, which is available to authorized users.

JEL ClassificationI15 health and economic development  Download fulltext PDF

Author: Giuseppe Turchetti - S. Bellelli - M. Amato - S. Bianchi - P. Conti - A. Cupisti - V. Panichi - A. Rosati - F. Pizzarelli


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