US payer budget impact of a microarray assay with machine learning to evaluate kidney transplant rejection in for-cause biopsies PubSummary

Key Takeaways

  • MMDx® Kidney is a cost-effective tool in kidney transplant recipients undergoing for cause biopsy.
  • MMDx Kidney in conjunction with histology can lead to savings of $19,271 over a 5-year period.
  • MMDx Kidney results in cost savings as long as graft failure in the year after biopsy is reduced by as little as 5%.

Summary Statement

A US payer budget model demonstrates that MMDx Kidney is a cost-effective intervention despite the cost of the assay and the higher treatment costs associated with identifying more rejection. 

Summary

The authors (including Dr. Chris Lawrence, Sr. Director, Business Development and Medical Affairs) present a budget impact model to estimate the economic impact to a US commercial payer of histology with MMDx Kidney compared to histology alone. In the base case scenario, the model assumes that MMDx Kidney reduces first-year graft failure rates by 25% from 5.5% to 4.1%. The model calculates undiscounted savings or losses in five separate model duration scenarios, from one to five years after for-cause biopsy.

Treatment costs and outcomes were derived from the United States Renal Data System (USRDS) database, Scientific Registry of Transplant Recipients (SRTR) database and Centers for Medicare and Medicaid Services data. Model assumptions were that patients received a single diagnosis, that one round of anti-rejection treatment was administered per patient, and that outcomes (death, graft failure, etc.) occurred after treatment had been completed. Therapies were derived from peer-reviewed sources and confirmed by two physicians.

Assuming one MMDx Kidney test per patient, MMDx Kidney results in undiscounted savings of $19,271 per test over a five-year period with positive savings starting in year two.

Break-even analysis shows that MMDx Kidney is effective if it results in at least a 5% reduction in graft loss.

Theoretically, MMDx Kidney could be used six times in five years before the costs of MMDx eliminate the savings.

By allowing better, more accurate diagnosis of rejection as well as increasing clinician confidence in diagnosis, MMDx Kidney may improve treatment options and reduce the total costs associated with graft failure. This model shows that MMDx Kidney can be an effective complement to histology alone when performed with for-cause biopsies.

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References
  1. Fusfeld, L., Menon, S., Gupta, G., Lawrence, C., Masud, S.F., & Goss, T.F. Journal of Medical Economics 2022, VOL. 25(1): 515-523 https://doi.org/10.1080/13696998.2022.2059221