A Within-Trial Economic Evaluation of a Patient Navigator Program in Children With CKD
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(Published version)
Date
2025
Authors
Chen, W.
Wong, G.
Howard, K.
Guha, C.
van Zwieten, A.
Natsky, A.N.
Mallitt, K.-A.
Khalid, R.
Francis, A.
Jaure, A.
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Kidney International Reports, 2025; 10(9):3202-3212
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Winnie Chen, Germaine Wong, Kirsten Howard, Chandana Guha, Anita van Zwieten, Andrea N. Natsky, Kylie-Ann Mallitt, Rabia Khalid, Anna Francis, Allison Jaure, Siah Kim, Armando Teixeira-Pinto, Amelie Bernier-Jean, David W. Johnson, Deirdre Hahn, Elizabeth G. Ryan, Hugh J. McCarthy, Charani Kiriwandeniya, Nicholas Larkins, Patrina Caldwell, Reginald Woodleigh, Simon A. Carter, Sean E. Kennedy, Stephen I. Alexander, Steven McTaggart, Jonathan C. Craig, Carmel M. Hawley, Martin Howell1 on behalf of the NAVKIDS2 Trial Steering Committee
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Abstract
Introduction: The NAVKIDS2 trial was a patient navigation program for children and their caregivers living with chronic kidney disease (CKD) in Australia. We conducted a within-trial economic evaluation to describe the cost-effectiveness of patient navigation compared with standard care. Methods: Cost and resource utilization data were prospectively collected over 6 months, from a health care funder perspective. Costs were reported in Australian dollars. Quality-of-life (QoL) data were collected from 0 to 6 months. Incremental cost-effectiveness ratios (ICERs) were reported as the additional cost/quality-adjusted life years (QALYs) gained. Results: Over the 6-month period, total per-patient costs were higher in the patient navigation group than in those in the standard care group ($10,249 vs. $9368, respectively; P < 0.001). There was no significant difference in mean health care costs between the 2 groups ($9848 vs. $9368, respectively, P = 0.98); however, the intervention group incurred an additional cost of $1075/person for the patient navigator. There was no significant difference in total QALYs over 6 months between patient navigation and standard care groups (0.33 vs. 0.30, respectively; P = 0.11). The ICER for the intervention group compared with usual care was $41,960/QALY gained with a wide 95% confidence interval (CI) (-$300,123 to +$769,958), indicating substantial uncertainty. Conclusion: The economic evaluation found that the cost of patient navigators is relatively low compared with total health care costs; however, there is considerable uncertainty regarding the cost-effectiveness of the intervention. Further research is needed to evaluate long-term cost-effectiveness as well as potential impacts on health outcomes and health care utilization.
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©2025 International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BY- NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).