BACKGROUND: Providing renal replacement therapy (RRT) for end-stage renal disease patients is resource intensive. Despite growing financial pressure in health care systems worldwide, cost-effectiveness studies of RRT modalities are scarce. METHODS: We developed a Markov model of costs, quality of life and survival to compare three different assignment strategies to chronic RRT in Europe. RESULTS: Mean annual treatment costs for haemodialysis were €43,600 during the first 12 months, €40,000 between 13 and 24 months and €40,600 beyond 25 months after initiation of treatment. Mean annual treatment costs for peritoneal dialysis were €25,900 during the first 12 months, €15,300 between 13 and 24 months and €20,500 beyond 25 months. Mean annual therapy costs for a kidney transplantation during the first 12 months were €50,900 from a living donor, €51,000 from a deceased donor, €17,200 between 13 and 24 months and €12,900 beyond 25 months after engraftment. Over the next 10 years in Austria with a population of 8 million people, increased assignment to peritoneal dialysis of 20% incident patients saved €26 million with a discount rate of 3% and gained 839 quality-adjusted life years (QALYs); additionally, increasing renal transplants to 10% from live donations saved €38 million discounted and gained 2242 QALYs. CONCLUSIONS: Live donor renal transplantation is cost effective and associated with increase in QALYs. Therefore, preemptive live kidney transplantation should be promoted from a fiscal as well as medical point of view.
BACKGROUND: Providing renal replacement therapy (RRT) for end-stage renal diseasepatients is resource intensive. Despite growing financial pressure in health care systems worldwide, cost-effectiveness studies of RRT modalities are scarce. METHODS: We developed a Markov model of costs, quality of life and survival to compare three different assignment strategies to chronic RRT in Europe. RESULTS: Mean annual treatment costs for haemodialysis were €43,600 during the first 12 months, €40,000 between 13 and 24 months and €40,600 beyond 25 months after initiation of treatment. Mean annual treatment costs for peritoneal dialysis were €25,900 during the first 12 months, €15,300 between 13 and 24 months and €20,500 beyond 25 months. Mean annual therapy costs for a kidney transplantation during the first 12 months were €50,900 from a living donor, €51,000 from a deceased donor, €17,200 between 13 and 24 months and €12,900 beyond 25 months after engraftment. Over the next 10 years in Austria with a population of 8 million people, increased assignment to peritoneal dialysis of 20% incident patients saved €26 million with a discount rate of 3% and gained 839 quality-adjusted life years (QALYs); additionally, increasing renal transplants to 10% from live donations saved €38 million discounted and gained 2242 QALYs. CONCLUSIONS: Live donor renal transplantation is cost effective and associated with increase in QALYs. Therefore, preemptive live kidney transplantation should be promoted from a fiscal as well as medical point of view.
Authors: Luis A Coentrão; Carla S Araújo; Carlos A Ribeiro; Claúdia C Dias; Manuel J Pestana Journal: Perit Dial Int Date: 2013-03-01 Impact factor: 1.756
Authors: F Friedersdorff; C Roller; G Klein; P Werthemann; H Cash; K Budde; T Slowinski; C Kempkensteffen; J Busch; T F Fuller; M Giessing Journal: World J Urol Date: 2012-08-18 Impact factor: 4.226
Authors: C Daniel Mullins; Rahul Jain; Matthew R Weir; Christine S Franey; Ya-Chen Tina Shih; Françoise G Pradel; Kaloyan Bikov; Stephen T Bartlett Journal: Transplantation Date: 2013-02-15 Impact factor: 4.939
Authors: Daniel K Nishijima; Zhuo Yang; John A Clark; Nathan Kuppermann; James F Holmes; Joy Melnikow Journal: Acad Emerg Med Date: 2013-11 Impact factor: 3.451
Authors: Alexander Chang; Emily E Anderson; Hang T Turner; David Shoham; Susan H Hou; Morgan Grams Journal: Clin Transplant Date: 2013-04-22 Impact factor: 2.863