199 RESULTS COST-EFFECTIVENESS The total costs per patient for the GoYK intervention and care-as-usual were €188,136 and €216,752, respectively, within the lifetime horizon. In the same period, total QALYs per patient for the GoYK intervention and care-as-usual were 7.28 and 6.91, respectively. This reflects an expected cost-saving of €28,616 and a gain of 0.37 QALYs per patient who received the GoYK intervention. The effects of the GoYK intervention on costs and QALYs were most evident in the first years, mainly due to the retardation of progression from CKD 3/4 to ESRD (Supplementary Figures 1a and 1b). In the first 10 years, the intervention averted 31 deaths and 113 new dialyses per 1,000 patients. Around 55% of the patients were deceased after 10 years in the intervention and control groups. This percentage increased to 90% after 17 years and 99% after 22 years. SENSITIVITY AND SCENARIO ANALYSES Probabilistic sensitivity analyses revealed that all the 10,000 simulations performed resulted in cost savings for the GoYK intervention. This is illustrated in Figure 6.2, where all simulations fell within the bottom right quadrant of the costeffectiveness plane. Univariate sensitivity analyses (Figure 6.3) showed that the model was most sensitive to the cost of ESRD and the effect of the intervention on the transition from CKD 3/4 to ESRD. The quality of life in CKD 1/2 and CKD 3/4 were the least influential parameters. Regardless of the parameters analyzed, the GoYK intervention remained cost-saving.
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