Cost-Effective Care of End-Stage Renal Disease: A Billion Dollar Question

1980 ◽  
Vol 92 (2_Part_1) ◽  
pp. 243 ◽  
Author(s):  
STEPHEN D. ROBERTS
Keyword(s):  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cost Effective ◽  
Effective Care ◽  
Stage Renal Disease ◽  
End Stage

Economic Evaluation of Kidney Transplantation versus Hemodialysis in Patients with End-Stage Renal Disease in Hungary

2001 ◽  
Vol 11 (3) ◽  
pp. 188-193 ◽  
Author(s):  
Zoltán Kaló ◽  
Jeno Járay ◽  
Júlia Nagy
Keyword(s):  
Kidney Transplantation ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cost Effective ◽  
Effective Option ◽  
Hungarian Population ◽  
Cadaveric Kidney ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Cost

Background— Kidney transplantation is generally acknowledged as the more clinically effective and more cost-effective option in managing patients with end-stage renal disease, compared with dialysis. This study looked for confirmatory evidence in a Hungarian population. Methods— Patients (n = 242) with end-stage renal disease who received cadaveric kidney transplantation during 1994 were followed up for 3 years. They were compared with patients (n = 840) receiving hemodialysis who were on a waiting list for transplantation. Data were collected retrospectively. Treatments were compared for clinical efficacy and for cost-effectiveness. Results— At month 36, the standard mortality hazard function was 3.5 times higher in the group receiving hemodialysis ( P<.0001) than in the transplant recipients. Average treatment costs per patient over the 3 years were also significantly higher ( P<.0001) in the hemodialysis group than in the group that received transplants. The cost of 1 year gained by transplantation was significantly less ( P<.0001) than the cost associated with hemodialysis. Conclusions— Compared with hemodialysis, kidney transplantation provides greater survival benefits to patients with end-stage renal disease, at less cost.

DIALYSIS FOR END-STAGE RENAL DISEASE

2001 ◽  
Vol 17 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Liz Kirby ◽  
Luke Vale
Keyword(s):  
Systematic Review ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cost Effective ◽  
Considerable Variability ◽  
The United Kingdom ◽  
Stage Renal Disease ◽  
End Stage ◽  
The Cost ◽  
Initial Method

Objective: Renal replacement therapy (RRT) is essential for maintenance of life for those with end-stage renal disease. However, there remain many areas of uncertainty about which method of RRT should be chosen. This paper reports an economic model based on a systematic review that attempts to determine which method of dialysis, continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis, a patient should have as the initial method of RRT.Methods: A systematic review and a costing exercise carried out in a Scottish hospital were used to populate a Markov model. Scenario analysis was used to model plausible variations in variables included in the model.Results: In 8 of the 16 scenarios developed hemodialysis dominated CAPD. In a further eight scenarios, the cost per life-year displayed considerable variability, ranging from between £5,000 to £51,000. The higher costs per life-year were associated with minimum estimates of additional survival for a patient starting RRT on hospital hemodialysis.Conclusion: It may be more cost-effective to manage patients starting on RRT with hospital hemodialysis than CAPD. This has particular implications for the United Kingdom, given that up to 50% of new patients receive CAPD.

Cost-Effectiveness Analysis of the Treatment of End-Stage Renal Disease in Brazil

1990 ◽  
Vol 6 (1) ◽  
pp. 107-114 ◽  
Author(s):  
Ricardo Sesso ◽  
John M. Eisenberg ◽  
Carlos Stabile ◽  
Sergio Draibe ◽  
Horacio Ajzen ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Related Donor ◽  
Stage Renal Disease ◽  
End Stage ◽  
Living Related

Cost-effectiveness analysis compared four treatments of end-stage renal disease in Brazil: continuous ambulatory peritoneal dialysis (CAPD), in-center hemodialysis (HD), cadaver donor transplantation (CD-Tx), and living related donor transplantation (LR-Tx). After 2 years, the costs per year of survival were CAPD, $12,134; HO, $10,065; CO-Tx, $6,978; and LR-Tx, $3,022. The HD cost was lower than CAPO partially because of the reuse of hemodialyzers in Brazil. Although less cost-effective, both dialysis treatments yielded more years of survival after 2 years. This analysis reveals a trade-off between cost per year of survival and years of survival.

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