Budget impact analysis of chronic kidney disease mass screening test in Japan

Our recently published cost-effectiveness study on chronic kidney disease mass screening test in Japan evaluated the use of dipstick test, serum creatinine (Cr) assay or both in specific health checkup (SHC). Mandating the use of serum Cr assay additionally, or the continuation of current policy mandating dipstick test only was found cost-effective. This study aims to examine the affordability of previously suggested reforms. Budget impact analysis was conducted assuming the economic model would be good for 15 years and applying a population projection. Costs expended by social insurers without discounting were counted as budgets. Annual budget impacts of mass screening compared with do-nothing scenario were calculated as Ayen79-Ayen-1,067 million for dipstick test only, Ayen2,505-Ayen9,235 million for serum Cr assay only and Ayen2,517-Ayen9,251 million for the use of both during a 15-year period. Annual budget impacts associated with the reforms were calculated as Ayen975-Ayen4,129 million for mandating serum Cr assay in addition to the currently used mandatory dipstick test, and Ayen963-Ayen4,113 million for mandating serum Cr assay only and abandoning dipstick test. Estimated values associated with the reform from Ayen963-Ayen4,129 million per year over 15 years are considerable amounts of money under limited resources. The most impressive finding of this study is the decreasing additional expenditures in dipstick test only scenario. This suggests that current policy which mandates dipstick test only would contain medical care expenditure.