BACKGROUND: Despite the growing interest in haemodiafiltration (HDF), there is no information on the costs and cost-utility of this dialysis modality yet. It was therefore our objective to study the cost-utility of HDF versus haemodialysis (HD). METHODS: A cost-utility analysis was performed using a Markov model. It included data from the Convective Transport Study (CONTRAST), a randomized controlled trial that compared online HDF with low-flux HD. Costs were estimated using a societal perspective. Probabilistic sensitivity analyses were performed to study uncertainty. RESULTS:Total annual costs for HDF and HD were €88 622±19,272 and €86,086±15,945, respectively (in 2009 euros). When modelled over a 5-year period, the incremental cost per quality-adjusted life year (QALY) of HDF versus HD was €287,679. Sensitivity analyses revealed that this amount will not fall below €140,000, even under the most favourable assumptions like a high-convection volume (>20.3 L). CONCLUSIONS: Based on accepted societal willingness-to-pay thresholds, HDF cannot be considered a cost-effective treatment for patients with end-stage renal disease at present. Apparently, minor additional costs of HDF are not counterbalanced by a relevant QALY gain.
RCT Entities:
BACKGROUND: Despite the growing interest in haemodiafiltration (HDF), there is no information on the costs and cost-utility of this dialysis modality yet. It was therefore our objective to study the cost-utility of HDF versus haemodialysis (HD). METHODS: A cost-utility analysis was performed using a Markov model. It included data from the Convective Transport Study (CONTRAST), a randomized controlled trial that compared online HDF with low-flux HD. Costs were estimated using a societal perspective. Probabilistic sensitivity analyses were performed to study uncertainty. RESULTS: Total annual costs for HDF and HD were €88 622±19,272 and €86,086±15,945, respectively (in 2009 euros). When modelled over a 5-year period, the incremental cost per quality-adjusted life year (QALY) of HDF versus HD was €287,679. Sensitivity analyses revealed that this amount will not fall below €140,000, even under the most favourable assumptions like a high-convection volume (>20.3 L). CONCLUSIONS: Based on accepted societal willingness-to-pay thresholds, HDF cannot be considered a cost-effective treatment for patients with end-stage renal disease at present. Apparently, minor additional costs of HDF are not counterbalanced by a relevant QALY gain.
Authors: Alexander V van Schoonhoven; Judith J Gout-Zwart; Marijke J S de Vries; Antoinette D I van Asselt; Evgeni Dvortsin; Pepijn Vemer; Job F M van Boven; Maarten J Postma Journal: PLoS One Date: 2019-09-06 Impact factor: 3.240
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Authors: Edouard L Fu; Marie Evans; Juan-Jesus Carrero; Hein Putter; Catherine M Clase; Fergus J Caskey; Maciej Szymczak; Claudia Torino; Nicholas C Chesnaye; Kitty J Jager; Christoph Wanner; Friedo W Dekker; Merel van Diepen Journal: BMJ Date: 2021-11-29
Authors: Ira M Mostovaya; Muriel P C Grooteman; Carlo Basile; Andrew Davenport; Camiel L M de Roij van Zuijdewijn; Christoph Wanner; Menso J Nubé; Peter J Blankestijn Journal: Clin Kidney J Date: 2015-06-10
Authors: Theresa Ermer; Christoph Kopp; John R Asplin; Ignacio Granja; Mark A Perazella; Martin Reichel; Thomas D Nolin; Kai-Uwe Eckardt; Peter S Aronson; Fredric O Finkelstein; Felix Knauf Journal: Kidney Int Rep Date: 2017-06-08
Authors: Juan G Ariza; Surrey M Walton; Adriana M Suarez; Mauricio Sanabria; Jasmin I Vesga Journal: Ther Apher Dial Date: 2021-01-31 Impact factor: 1.762