Kidney Function Test Could Save Payers $1 Billion in 5 Years

The use of an artificial intelligence-enabled diagnostic test that predicts kidney function decline in patients with type 2 diabetic kidney disease offers substantial savings to US payers, according to study results published online ahead of print in the Journal of Medical Economics.

“The KidneyIntelX test combines a blood test to measure circulating plasma biomarkers including sTNFR1, sTNFR2, and KIM-1 with clinical variables from electronic health records to create a test score from 5-100,” researchers explained. “This score is then used to stratify patients into low, intermediate, or high risk of experiencing progression over 5 years.”

The study compared the US payer budget impact of KidneyIntelX-guided care compared with standard of care in a hypothetical cohort of 100,000 patients with stage 1 through stage 3b type 2 diabetic kidney disease over 5 years. KidneyIntelX costs included the cost of the test, additional use of prescription medications, referrals to specialists, and primary care visits. Patients managed with the test experienced a 20% slowed progression rate compared with standard of care.

In a base-case scenario, projected undiscounted 5-year health plan savings for 100,000 patients tested one time with KidneyIntelX were $1.052 billion, or $10,522 per patient. Cost savings were mostly due to slowed progression through diabetic kidney disease stages, according to the study.

A health plan could expect to break even just prior to year 2 after KidneyIntelX adoption. Afterward, savings would likely “increase substantially in each consecutive year,” researchers reported, “with savings reaching $513 million in year 5 alone.”

At the most conservative effect-size, a health plan could expect to save $145 million over 5 years, sensitivity analysis showed. At just a 5% slowed progression rate and the most conservative definition of progression, the payer would break even between years 3 and 4.

On the other hand, a 35% slowed progression rate and the least stringent definition of progression projected $2.107 billion in savings and a breakeven point just 1 year after KidneyIntelX adoption.

“KidneyIntelX shows considerable promise in not only identifying patients’ risk of progressive decline in kidney function, but also resulting in economic savings for the health plan in the long run,” researchers wrote.

Reference:
Datar M, Burchenal W, Donovan MJ, Coca SG, Wang E, Goss TF. Payer budget impact of an artificial intelligence in vitro diagnostic to modify diabetic kidney disease progression [published online ahead of print, 2021 Jul 26]. J Med Econ. 2021;1. doi:10.1080/13696998.2021.1960714