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Arch Hellen Med, 26(5), September-October 2009, 668-677


Insurance coverage for the treatment of patients with chronic renal insufficiency.
Adoption of economic assessment by the Institute of Social Insurance (IKA)

1Faculty of Social Sciences, University of Peloponnese, Corinth,
2University for Postgraduate Studies "Public Health and Administration of Health Services", Medical School, University of Crete, Heraklion,
3"G. Papadakis" General Hospital of Nikea, Nephrology Center, Nikea, Greece

Chronic kidney disease (CKD) constitutes a multidimensional problem for both the patients but also the state. The number of patients with final stage chronic kidney disease (FSCKD) has reached dimensions of epidemic in the entire world, while, according to recent data, Greece ranks in the 8th place in a global comparison of prevalence of patients in treatment of substitution of renal function (RRT), with this pool of patients increasing by 5-7% annually. This increase translates to an enormous economic strain for the funds of social insurance on the one hand but also with regards to the quality of life of patients and their families. Indicatively, it is estimated that IKA alone annually spends 37,000 € for each patient in renal replacement treatment. One of the problems presented early in the development of disease (stages 3 and 4) is secondary hyperparathyroidism which is linked to the increase of complications and resulting hospitalisations of patients, and accordingly further increased costs for both the patient and the system. "Z" is linked to the prevention and treatment of secondary hyperparathyroidism in patients with CKD stages 3, 4 and 5 and is also linked to the increase of survival and delay of procession to RRT.

OBJECTIVE The aim of the present study was to appreciate the effectiveness, the efficiency and the benefit that will result from the assumption of cost of contribution (25%) to the expense of the drug from IKA.

METHOD The data used are epidemiologic (prevalence of stages CKD, RRT, and secondary hyperparathyroidism in Greece), the cost caused by patients to the system, as well as the social cost patients experience, while data are mentioned relative to the effectiveness of "Z", and the, according to international published studies, proven economic benefits from its use.

RESULTS-CONCLUSIONS We reached the conclusion that if IKA was to bear part of the cost contribution (additional annual expense 10,647,120 €) would in the long term result in a 39,926,700 € benefit due to the delay of a percentage of patients entering stage 5.

Key words: Chronic kidney disease, Economic evaluation, Quality of life, Reimbursement.

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