These hurdles are appraised by cost-effectiveness

analysis and budget impact analysis, respectively. Cost-effectiveness analysis concerns efficiency of resources use based on the valuations of cost and effectiveness at the same time comparing technical alternatives, while budget impact analysis concerns affordability of the government #selleck chemicals llc randurls[1|1|,|CHEM1|]# or the third party payer by demonstrating changes of cash flows as a result of making an intervention accessible for the population Methods We conducted a budget impact analysis of CKD screening test in SHC based on our previous economic model reporting cost-effectiveness [12]. As shown in Fig. 1, the CBL0137 budget impact analysis is to demonstrate budget changes in terms of cash flows, in which payer’s perspective is always taken; health outcomes are excluded; and financial costs are included. As the summary of the economic model constructed in our previous cost-effectiveness analysis is shown in Table 1, it evaluated two reform policy options based on the economic model comparing do-nothing scenario with dipstick test only, serum Cr assay only, and both. The two policies were:

mandate the use of serum Cr assay in addition to the current dipstick test (Policy 1); or mandate the use of serum Cr assay only and abandon dipstick test (Policy 2). Policy 1 meant that the

current SHC practice, which was a mandatory 100 % use of dipstick test with 60 % use of serum Cr assay at discretion, would become a mandatory 100 % use of both dipstick Florfenicol test and serum Cr assay; while Policy 2 meant that the current practice would switch to the mandatory 100 % use of serum Cr assay and no use (0 %) of dipstick test. The latter assumption was made by the change in diagnosis criterion of diabetes [18], in which a blood test to check the level of haemoglobin A1c instead of a dipstick test to check urinary sugar level had become pivotal. And the model estimator comparing do-nothing scenario with dipstick test only scenario reflected the choice of continuing the current policy. Our budget impact analysis evaluated these policy options. Table 1 Summary of cost-effectiveness of chronic kidney disease (CKD) screening test in Japan Objective The study aims to assess the cost-effectiveness of population strategy, i.e. mass screening, for CKD control and Japan’s health checkup reform Methods Cost-effectiveness analysis was carried out to compare test modalities in the context of reforming Japan’s mandatory annual health checkup for adults.