TY - JOUR
T1 - Cost-Effectiveness of Behavior Modification Intervention for Patients With Chronic Kidney Disease in the FROM-J Study
AU - Okubo, Reiko
AU - Kondo, Masahide
AU - Hoshi, Shu Ling
AU - Okada, Masafumi
AU - Doi, Mariko
AU - Takahashi, Hideto
AU - Kai, Hirayasu
AU - Saito, Chie
AU - Iseki, Kunitoshi
AU - Iseki, Chiho
AU - Watanabe, Tsuyoshi
AU - Narita, Ichiei
AU - Matsuo, Seiichi
AU - Makino, Hirofumi
AU - Hishida, Akira
AU - Yamagata, Kunihiro
N1 - Funding Information:
Support: This study was supported by a grant for a strategic outcome study project from the Ministry of Health, Labour and Welfare of Japan. The study was also supported in part by a Grant-in-Aid for Research on Advanced Chronic Kidney Disease (REACH-J), Practical Research Project for Renal Diseases, Japan Agency for Medical Research and Development, AMED (Grant number JP20ek0310005). This study was also supported by a Grant-in-Aid for Scientific Research (B) (Grant number 19H03865) in Japan.The authors express their thanks to the doctors and dietitians who participated in this study. The authors are also grateful for the continuous support from the members of the Japanese Society of Nephrology, the Japan Dietetic Association, and the Japanese Medical Association. Financial Disclosure: None.
Publisher Copyright:
© 2021 National Kidney Foundation, Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Objectives: Chronic kidney disease (CKD) is a significant public health problem. An advanced, or innovative, CKD care system of clinical practice collaboration among general physicians (GPs), nephrologists, and other healthcare workers achieved behavior modification in patients with Stage 3 CKD in the Frontier of Renal Outcome Modifications in Japan (FROM-J) study. This behavior modification intervention consisted of educational sessions on nutrition and lifestyle, as well as encouragement of patients’ regular visits. The intervention contributed to slowing CKD progression. This study aimed to evaluate the cost-effectiveness of the widespread diffusion of the behavior modification intervention proven effective by the FROM-J study. Methods: A cost-effectiveness analysis was carried out to compare the behavior modification intervention with the current practice recommended by the latest CKD clinical guidelines for GPs. A Markov model with a societal perspective under Japan's health system was constructed. We assumed that the behavior modification intervention proven effective by the FROM-J study would be initiated by GPs for targeted patient cohorts—patients aged 40-74 years with Stage 3 CKD—as a part of the innovative CKD care system. Results: The incremental cost-effectiveness ratio for the behavior modification intervention compared with current guideline-based practice was calculated as 145,593 Japanese yen (¥; $1,324 United States dollars [$]) per quality-adjusted life year (QALY). Conclusions: Using the suggested value of social willingness to pay for a one-QALY gain in Japan of ¥5 million (US$45,455) as the threshold to judge cost-effectiveness, the behavior modification intervention is cost-effective. Our results suggest that diffusing the behavior modification intervention proven effective by the FROM-J study could be justifiable as an efficient use of finite healthcare resources. GPs could be encouraged to initiate this intervention by revising the National Health Insurance fee schedule and strengthening clinical guidelines regarding behavior modification interventions.
AB - Objectives: Chronic kidney disease (CKD) is a significant public health problem. An advanced, or innovative, CKD care system of clinical practice collaboration among general physicians (GPs), nephrologists, and other healthcare workers achieved behavior modification in patients with Stage 3 CKD in the Frontier of Renal Outcome Modifications in Japan (FROM-J) study. This behavior modification intervention consisted of educational sessions on nutrition and lifestyle, as well as encouragement of patients’ regular visits. The intervention contributed to slowing CKD progression. This study aimed to evaluate the cost-effectiveness of the widespread diffusion of the behavior modification intervention proven effective by the FROM-J study. Methods: A cost-effectiveness analysis was carried out to compare the behavior modification intervention with the current practice recommended by the latest CKD clinical guidelines for GPs. A Markov model with a societal perspective under Japan's health system was constructed. We assumed that the behavior modification intervention proven effective by the FROM-J study would be initiated by GPs for targeted patient cohorts—patients aged 40-74 years with Stage 3 CKD—as a part of the innovative CKD care system. Results: The incremental cost-effectiveness ratio for the behavior modification intervention compared with current guideline-based practice was calculated as 145,593 Japanese yen (¥; $1,324 United States dollars [$]) per quality-adjusted life year (QALY). Conclusions: Using the suggested value of social willingness to pay for a one-QALY gain in Japan of ¥5 million (US$45,455) as the threshold to judge cost-effectiveness, the behavior modification intervention is cost-effective. Our results suggest that diffusing the behavior modification intervention proven effective by the FROM-J study could be justifiable as an efficient use of finite healthcare resources. GPs could be encouraged to initiate this intervention by revising the National Health Insurance fee schedule and strengthening clinical guidelines regarding behavior modification interventions.
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U2 - 10.1053/j.jrn.2020.12.008
DO - 10.1053/j.jrn.2020.12.008
M3 - Article
C2 - 33744060
AN - SCOPUS:85102751946
VL - 31
SP - 484
EP - 493
JO - Journal of Renal Nutrition
JF - Journal of Renal Nutrition
SN - 1051-2276
IS - 5
ER -
