#4026 ECONOMIC EVALUATION OF ANAEMIA OF CHRONIC KIDNEY DISEASE (CKD): A SYSTEMATIC LITERATURE REVIEW AND MODEL CONCEPTUALISATION

Abstract Background and Aims Anaemia is a common complication of chronic kidney disease (CKD), affecting up to 53.4% patients with Stage 5 CKD compared 8.4% 1 [1]. associated increased risk cardiovascular events death, healthcare resource utilisation (HRU), reduced health-related quality life (HRQoL) [2]. Established treatments for anaemia include erythropoiesis-stimulating agents (ESAs) [1,2]; however, hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs), targeting both erythropoietin production iron metabolism (the two key mechanisms CKD), are an emerging class in this indication [3]. The cost HRQoL burden treatment not well characterised.1 Thus, we conducted systematic literature review (SLR) evaluate published economic models (including the inputs, time horizon, subgroups, clinical assumptions used) HRU data CKD. Findings SLR will help guide future model development inform evaluation strategies as part health technology assessment submissions support daprodustat, HIF-PHI under use dialysis-dependent non-dialysis-dependent patients. Method Relevant publications were identified using structured searching MEDLINE, Embase, MEDLINE In-Process, Cochrane Controlled Trials Register, Database Systematic Reviews from database inception 10 April 2022 disease- (e.g. CKD, failure, anaemia) economic-associated economics, evaluation, quality-adjusted life-years, structure) search terms. Additional supplemental searches (conference proceedings [2016–2021], grey literature, bibliographies) conducted. Studies assessed inclusion or exclusion by independent reviewers, any discrepancies resolved third reviewer. Objectives determine structure availability utility additional complications examine what horizons, used modelling. Results From 1397 citations searches, 40 primary studies included final analysis. Review revealed established approach modelling ESA cost-effectiveness (i.e. Markov states defined according received status): most North American European perspective, horizons varied, reporting cycle length was poor. Only one model: given different action ESAs newer treatments, strategy focused mainly on may be optimal way assessing where HIF-PHIs used. Considerations factors that could influence shown Fig. 1. While existing typically only stratified patient populations age (<65 vs >65 years), appropriate effectiveness, impact prior response ESAs) also considered. As every model, comorbidities have role effect modification need considered treatment. Due natural history innovative techniques retain which account respective haemoglobin levels, stage, potential transplantation should incorporated into (Fig. 2). Conclusion Adjustment approaches described provide more reliable estimates efficacy highly heterogenous population