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Pharmaceutical cost distribution in childhood chronic kidney disease
Janis M Dionne1, Kelvin Lou, Lee Er
1Department of Pediatrics, Division of Nephrology, BC Children's Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada. jdionne@cw.bc.ca
Insights
Pharmaceutical costs in pediatric chronic kidney disease (CKD) are significant, with growth and nutrition being the most expensive drug categories. Understanding these costs is crucial for effective financial planning in pediatric CKD clinics.
Area of Science:
- Nephrology
- Pharmacoeconomics
- Pediatric Health
Background:
- Chronic kidney disease (CKD) presents substantial economic challenges.
- Pharmaceutical cost analyses are infrequent despite the critical role of drug therapy in CKD management.
Purpose of the Study:
- To analyze drug cost distribution in pediatric patients with chronic kidney disease (CKD).
- To identify key drug categories contributing to pharmaceutical expenses in pediatric CKD.
Main Methods:
- An observational, retrospective review of drug costs was conducted.
- The study included prevalent pediatric CKD patients (1 month to 20 years) at a Canadian tertiary care center.
- Data were collected between January 1 and December 31, 2009.
Main Results:
- The cohort (n=148) incurred annual pharmaceutical costs just under $250,000, averaging $1,800 per patient annually.
- Growth and nutrition, anemia, hypertension, and bone metabolism were the highest cost drug categories.
- Drug costs increased with CKD stage, and adherence was not demonstrated across any category.
Conclusions:
- Pediatric CKD pharmaceutical costs per patient are comparable to adults, but the cost distribution differs significantly.
- Increased awareness of pediatric-specific needs can lead to more cost-effective financial planning in pediatric nephrology.
Background:
Chronic kidney disease (CKD) is associated with significant economic burdens to both patients and the healthcare system, but pharmaceutical cost analyses are uncommon despite drug therapy being a cornerstone of CKD management.
Methods:
This observational, retrospective review of drug cost distribution at a single tertiary care pediatric nephrology program in Canada was conducted on prevalent patients with CKD aged 1 month to 20 years, between 1 January and 31 December 2009.
Results:
The time-adjusted annual pharmaceutical cost of our cohort (n = 148) was just below US $250,000 with a cost per patient per year of $1,800. The highest costs were in the growth and nutrition category, followed by anemia, hypertension and bone metabolism. Total drug cost per patient increased as CKD stage advanced. Adherence was not demonstrated in any drug category, and the mean daily pill burden was nine (range 2-23).
Conclusions:
This study has shown that while the annual pharmaceutical costs on a per patient basis are similar between children and adults, the cost distribution is very different. An increase in awareness of the unique needs of the pediatric population should allow for more cost-effective financial planning in pediatric CKD clinics.
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