An Empiric Estimate of the Value of Life: Updating the Renal Dialysis Cost-Effectiveness Standard

Lee, Chris P.; Chertow, Glenn M.; Zenios, Stefanos A.

doi:10.1111/j.1524-4733.2008.00401.x

Cited by 175 publications

(110 citation statements)

References 21 publications

(30 reference statements)

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“…However, investigators in a more recent analysis have estimated that the average ICER per QALY of dialysis in current practice compared with the next least costly alternative is $129,000, with a range of $65,496 to $488,360. 39 Furthermore, assessing the cost-effectiveness of a drug or intervention is just one part of a treatment plan that may include hospitalization costs, surgeries and procedures, radiotherapy, and indirect costs due to lost wages. It is, therefore, evident how difficult it is to establish a threshold ICER to help guide and formulate policy decisions.…”

Section: What Polices or Interventions Can Be Used To Lower The Cost mentioning

confidence: 99%

The High Cost of Cancer Drugs and What We Can Do About It

Siddiqui

Rajkumar

2012

Mayo Clinic Proceedings

218

210

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Section: What Polices or Interventions Can Be Used To Lower The Cost mentioning

confidence: 99%

The High Cost of Cancer Drugs and What We Can Do About It

Siddiqui

Rajkumar

2012

Mayo Clinic Proceedings

218

210

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“…A study by the same investigators of elderly nursing home patients starting dialysis revealed even worse results, with 87% of them dying or experiencing a functional decline in the first year after dialysis initiation (25). Not surprisingly, cost utility analyses reveal that elderly patients with ESRD have higher ICERs than younger patients (19,26).…”

Section: Restricting Access To Dialysismentioning

confidence: 99%

“…Traditionally, an intervention has been considered economically justified at #$50,000/QALY (18). Investigators recently estimated the ICER of dialysis compared with that of palliative care to be $110,814/QALY (19).…”

Section: How Will the Government Measure The Value Of Care?mentioning

confidence: 99%

The Coming Fiscal Crisis

Andersen

Friedman

2013

Clinical Journal of the American Society of Nephrology

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SummaryNephrologists in the United States face a very uncertain economic future. The astronomical federal debt and unfunded liability burden of Medicare combined with the aging population will place unprecedented strain on the health care sector. To address these fundamental problems, it is conceivable that the federal government will ultimately institute rationing and other budget-cutting measures to rein in costs of ESRD care, which is generously funded relative to other chronic illnesses. Therefore, nephrologists should expect implementation of cost-cutting measures, such age-based rationing, mandated delayed dialysis and home therapies, compensated organ donation, and a shift in research priorities from the dialysis to the predialysis patient population. Nephrologists also need to recognize that these changes, which are geared toward the population level, may make it more difficult to advocate effectively for the needs of individual patients.

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“…The cancer risk in terms of DALY was obtained as 8.48×10 -7 per person per year (PPPY), which was lower than the USEPA guideline value of 1.0×10 -6 [27]. One DALY was associated with a loss of US$ 108,600 [28], which means one year of healthy human life costs US$ 108,600, indicating that the total financial burden for Saudi Arabia was US$ 2.72 million with the range of US$ 2.52 -2.91 million per year. …”

Section: Risks Of Thmsmentioning

confidence: 99%

Desalinated and blended water in Saudi Arabia: human exposure and risk analysis from disinfection byproducts

Chowdhury

2017

MATEC Web Conf.

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Abstract. Saudi Arabia produces the largest amount of desalinated water as a single country. The desalinated water is typically blended with treated groundwater, pH adjusted and chlorinated prior to supply to the communities. The desalinated seawater and/or blended water contains various types of disinfection byproducts (DBPs), some of which may induce cancer risks to human through lifetime exposure. In this study, occurrences of trihalomethanes (THMs) in desalinated and blended water in Saudi Arabia were investigated and their exposure and risks were predicted. The chronic daily intakes of CHCl3, BDCM, DBCM and CHBr3 were estimated to be 8.38×10 -5 , 7.57×10 -5 , 2.54×10 -5 and 4.32×10 -4 mg/kg-day respectively. The overall cancer risk was 1.78×10 -5 with the range of 7.40×10 -7 -9.26×10 -5 and the average hazard index was 3.49×10 -2 with the range of 1.20×10 -3 -2.34×10 -1 . The loss of disability adjusted life years (DALY) were estimated to be 25.1 per year and the average cancer risk had 8.48×10 -7 DALY per person per year. The financial burden was estimated to be US$2.72 million with the range of US$2.52-2.91 million. The findings may assist in better understanding and reducing cancer risks from DBPs in desalinated and blended water.

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An Empiric Estimate of the Value of Life: Updating the Renal Dialysis Cost-Effectiveness Standard

Cited by 175 publications

References 21 publications

The High Cost of Cancer Drugs and What We Can Do About It

The High Cost of Cancer Drugs and What We Can Do About It

The Coming Fiscal Crisis

Desalinated and blended water in Saudi Arabia: human exposure and risk analysis from disinfection byproducts

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