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Pharmaceutical cost distribution in childhood chronic kidney disease

Pediatric Nephrology volume 27, pages 1531–1539 (2012)Cite this article

Abstract

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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Acknowledgments

We would like to thank Malou Alvarez for assistance and Helia Akbari for providing compounding cost information. We would also like to thank Ognjenka Djurdjev for her expertise and assistance in data gathering, and Drs. Lee-Son and Matsell for their thoughtful reviews of prior drafts.

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Affiliations

  1. Department of Pediatrics, Division of Nephrology, BC Children’s Hospital, University of British Columbia, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada

    Janis M. Dionne & Colin T. White

  2. Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada

    Kelvin Lou & Kathleen Collin

  3. British Columbia Provincial Renal Agency, Vancouver, BC, Canada

    Lee Er

Authors
  1. Janis M. Dionne
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  2. Kelvin Lou
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  3. Lee Er
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  4. Kathleen Collin
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  5. Colin T. White
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Corresponding author

Correspondence to Janis M. Dionne.

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Dionne, J.M., Lou, K., Er, L. et al. Pharmaceutical cost distribution in childhood chronic kidney disease. Pediatr Nephrol 27, 1531–1539 (2012). https://doi.org/10.1007/s00467-012-2165-1

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  • DOI: https://doi.org/10.1007/s00467-012-2165-1

Keywords

  • Pediatrics
  • Cost analysis
  • Drug costs
  • Nutritional requirements
  • Anemia
  • Metabolic bone diseases
  • Medication adherence