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Article: Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

TitleLifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy
Authors
KeywordsCost-effectiveness
Economic burden
End-stage renal disease
Peritoneal dialysis first
Dialysis
Issue Date2020
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcnephrol/
Citation
BMC Nephrology, 2020, v. 21 n. 1, p. article no. 42 How to Cite?
AbstractBackground: This study aimed to determine the lifetime cost-effectiveness of first-line dialysis modalities for end-stage renal disease (ESRD) patients under the “Peritoneal Dialysis First” policy. Methods: Lifetime cost-effectiveness analyses from both healthcare provider and societal perspectives were performed using Markov modelling by simulating at age 60. Empirical data on costs and health utility scores collected from our studies were combined with published data on health state transitions and survival data to estimate the lifetime cost, quality-adjusted life-years (QALYs) and cost-effectiveness of three competing dialysis modalities: peritoneal dialysis (PD), hospital-based haemodialysis (HD) and nocturnal home HD. Results: For cost-effectiveness analysis over a lifetime horizon from the perspective of healthcare provider, hospital-based HD group (lifetime cost USD$142,389; 6.58 QALYs) was dominated by the PD group (USD$76,915; 7.13 QALYs). Home-based HD had the highest effectiveness (8.37 QALYs) but with higher cost (USD$97,917) than the PD group. The incremental cost-effectiveness ratio (ICER) was USD$16,934 per QALY gained for home-based HD over PD. From the societal perspective, the results were similar and the ICER was USD$1,195 per QALY gained for home-based HD over PD. Both ICERs fell within the acceptable thresholds. Changes in model parameters via sensitivity analyses had a minimal impact on ICER values. Conclusions: This study assessed the cost-effectiveness of dialysis modalities and service delivery models for ESRD patients under “Peritoneal Dialysis First” policy. For both healthcare provider and societal perspectives, PD as first-line dialysis modality was cost-saving relative to hospital-based HD, supporting the existing PD First or favoured policy. When compared with PD, Nocturnal home Home-based HD was considered a cost-effective first-line dialysis modality for ESRD patients.
Persistent Identifierhttp://hdl.handle.net/10722/280367
ISSN
2018 Impact Factor: 2.088
2015 SCImago Journal Rankings: 1.113

 

DC FieldValueLanguage
dc.contributor.authorWong, CKH-
dc.contributor.authorChen, J-
dc.contributor.authorFung, SKS-
dc.contributor.authorMok, M-
dc.contributor.authorCheng, YL-
dc.contributor.authorKong, I-
dc.contributor.authorLo, WK-
dc.contributor.authorLui, SL-
dc.contributor.authorChan, TM-
dc.contributor.authorLam, CLK-
dc.date.accessioned2020-02-07T07:40:04Z-
dc.date.available2020-02-07T07:40:04Z-
dc.date.issued2020-
dc.identifier.citationBMC Nephrology, 2020, v. 21 n. 1, p. article no. 42-
dc.identifier.issn1471-2369-
dc.identifier.urihttp://hdl.handle.net/10722/280367-
dc.description.abstractBackground: This study aimed to determine the lifetime cost-effectiveness of first-line dialysis modalities for end-stage renal disease (ESRD) patients under the “Peritoneal Dialysis First” policy. Methods: Lifetime cost-effectiveness analyses from both healthcare provider and societal perspectives were performed using Markov modelling by simulating at age 60. Empirical data on costs and health utility scores collected from our studies were combined with published data on health state transitions and survival data to estimate the lifetime cost, quality-adjusted life-years (QALYs) and cost-effectiveness of three competing dialysis modalities: peritoneal dialysis (PD), hospital-based haemodialysis (HD) and nocturnal home HD. Results: For cost-effectiveness analysis over a lifetime horizon from the perspective of healthcare provider, hospital-based HD group (lifetime cost USD$142,389; 6.58 QALYs) was dominated by the PD group (USD$76,915; 7.13 QALYs). Home-based HD had the highest effectiveness (8.37 QALYs) but with higher cost (USD$97,917) than the PD group. The incremental cost-effectiveness ratio (ICER) was USD$16,934 per QALY gained for home-based HD over PD. From the societal perspective, the results were similar and the ICER was USD$1,195 per QALY gained for home-based HD over PD. Both ICERs fell within the acceptable thresholds. Changes in model parameters via sensitivity analyses had a minimal impact on ICER values. Conclusions: This study assessed the cost-effectiveness of dialysis modalities and service delivery models for ESRD patients under “Peritoneal Dialysis First” policy. For both healthcare provider and societal perspectives, PD as first-line dialysis modality was cost-saving relative to hospital-based HD, supporting the existing PD First or favoured policy. When compared with PD, Nocturnal home Home-based HD was considered a cost-effective first-line dialysis modality for ESRD patients.-
dc.languageeng-
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcnephrol/-
dc.relation.ispartofBMC Nephrology-
dc.rightsBMC Nephrology. Copyright © BioMed Central Ltd.-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectCost-effectiveness-
dc.subjectEconomic burden-
dc.subjectEnd-stage renal disease-
dc.subjectPeritoneal dialysis first-
dc.subjectDialysis-
dc.titleLifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy-
dc.typeArticle-
dc.identifier.emailWong, CKH: carlosho@hku.hk-
dc.identifier.emailChen, J: juliechen@hku.hk-
dc.identifier.emailMok, M: mmymok@hku.hk-
dc.identifier.emailLo, WK: wkloc@hkucc.hku.hk-
dc.identifier.emailLui, SL: sllui@hkucc.hku.hk-
dc.identifier.emailChan, TM: dtmchan@hkucc.hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityWong, CKH=rp01931-
dc.identifier.authorityChen, J=rp00526-
dc.identifier.authorityChan, TM=rp00394-
dc.identifier.authorityLam, CLK=rp00350-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1186/s12882-020-1708-0-
dc.identifier.pmid32019528-
dc.identifier.hkuros309095-
dc.identifier.volume21-
dc.identifier.issue1-
dc.identifier.spagearticle no. 42-
dc.identifier.epagearticle no. 42-
dc.publisher.placeUnited Kingdom-

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