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doi:10.1111/nep.2009.14.issue-1

Cited by 1 publication

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“…Given the above data, the appropriate widespread utilization of PD would require an extensive evaluation of its socioeconomic significance, while understanding that changes in medical technology are also required. Although a modicum of medical economics-based evidence for PD does exist, economic assessment and identification of the factors that influence automated PD (APD) machines, which are being increasingly introduced in the clinical setting, have yet to be sufficiently examined 8,9. In particular, in Japan, although the long-term follow-up results, such as the vital prognosis of dialysis therapy, were reported to be better than those in most other countries,10 the cost-effectiveness of PD is yet to be evaluated.…”

Section: Introductionmentioning

confidence: 99%

<p>Health economic evaluation of peritoneal dialysis based on cost-effectiveness in Japan: a preliminary study</p>

Takura¹,

Hiramatsu²,

Nakamoto³

et al. 2019

CEOR

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BackgroundIn Japan, the medical expenditures associated with dialysis have garnered considerable interest; however, a cost-effectiveness evaluation of peritoneal dialysis (PD) is yet to be evaluated. In particular, the health economics of the “PD first” concept, which can be advantageous for clinical practice and healthcare systems, must be evaluated.MethodsThis multicenter study investigated the cost-effectiveness of PD. The major effectiveness indicator was quality-adjusted life year (QALY), with a preference-based utility value based on renal function, and the cost indicator was the amount billed for a medical service at each medical institution for qualifying illnesses. In comparison with hemodialysis (HD), a baseline analysis of PD therapy was conducted using a cost-utility analysis (CUA). Continuous ambulatory PD (CAPD) and automated PD (APD) were compared based on the incremental cost-utility ratio (ICUR) and propensity score (PS) with a limited number of cases.ResultsThe mean duration since the start of PD was 35.0±14.4 months. The overall CUA for PD (179 patients) was USD 55,019/QALY, which was more cost effective (USD/monthly utility) compared with that for HD for 12–24 months (4,367 vs. 4,852; p<0.05). The CUA reported significantly better results in the glomerulonephritis group than in the other diseases, and the baseline CUA was significantly age sensitive. The utility score was higher in the APD group (mean age, 70.1±3.5 years) than in the CAPD group (mean age, 70.6±4.2 years; 0.987 vs. 0.860; p<0.05, 9 patients). Compared with CAPD, APD had an overall ICUR of USD 126,034/QALY.ConclusionThe cost-effectiveness of PD was potentially good in the elderly and in patients on dialysis for <24 months. Therefore, the prevalence of PD may influence the public health insurance system, particularly when applying the “PD first” concept.

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Section: Introductionmentioning

confidence: 99%