Cost of dialysis in Tanzania: evidence from the provider’s perspective

Abstract

BackgroundAlthough End Stage Renal Disease (ESRD) is a disease of increasing epidemiological relevance very little is known about the cost of providing the respective dialysis services in Tanzania. This paper estimates the costs of dialysis for ESRD patients at Muhimbili National Hospital (MNH) in Tanzania in the year 2014.MethodsCost calculations are based on the provider perspective and include only the direct cost of dialysis treatment. Cost of drugs and consumables were obtained from the price list issued by the Medical Stores Department (MSD) in Tanzania. Additional data were collected through face-to-face interview with experts at the dialysis unit.ResultsMNH performs on average 442 hemodialysis per month (34 patients, with three sessions per week) with a personnel placement of 20 nurses, four nephrologists, eight registrars, one nutritionist, two biomedical engineers, four health attendants and nine dialysis machines. The respective average unit cost per hemodialysis is 176 US$. Consequently, an average patient requiring three dialyses per week (i.e. 156 dialyses per year) will cause annual costs of 27,440 US$.ConclusionThe cost of dialysis is enormous for a least developed country like Tanzania where resources and technology are rather limited. Thus, from the economic point of view, it seems rational to allocate health care budgets towards diseases that are curable, have a higher cost-effectiveness and cater for the majority of the population. However, before a final decision on allocation of budgets towards dialysis is made all effort must be invested to improve technical efficiency by cutting the enormous unit cost.

Challenges and outcomes of haemodialysis among patients presenting with kidney diseases in Dodoma, Tanzania

“…Most developed countries can provide peritoneal dialysis (PD) at a lesser expense as compared to HD, the evidence from developing countries is more mixed, but in most cases PD can be provided at a similar cost to HD where economies of scale have been achieved, either by local production or by low import duties on PD equipment [9, 10]. These programs can be sustainable only when governments can afford to support them by allocating funds in their national health budgets [11].…”

Cost estimate of chronic hemodialysis in Kinshasa, the Democratic Republic of the Congo: A prospective study in two centers

“…We believe that early management of patients with CKD would help reduce the number of comorbidities, especially cardiovascular diseases. 33 CKD and the ESRD extent in the DRC as demonstrated by previous studies 20,27 and cause a very heavy economic burden in this country's health sector. Thus, it is imperative to find appropriate strategies for SSA countries by implementing universal health coverage.…”

“…Although it is difficult to compare analyses carried out at different centers (cost evaluation depends on a variety of factors), the mean annual expenditure per patient on HD-related care in US$ is 28,280 in Kinshasa, which is significantly higher than that reported in Cameroon (U $13,581), 23 Morocco (US$12,000), 11 lran (US$11,549) 24 and India (US$4821) 25 but similar to the annual cost reported in Brazil (US$28,570) 26 and Tanzania (US$27,440). 27 This annual expense per Congolese HD patient is, however, relatively lower than the HD cost from other countries (€81,500 in France, 16 US$68,000 in the USA 13 and US$46,332 in Saudi Arabia 28 ). This discrepancy in the direct cost of HD-related care may due to differences between countries in state subsidies, health coverage, HD adherence, current drugs prescribed (EPO, iron, calcimimetic, etc.…”

Non-medical facilitators and barriers towards accessing haemodialysis services: an exploration of ethical challenges

“…It has a total of 16 working dialysis machines. Generally, 75% of all haemodialysis services in Tanzania are offered in Dar es Salaam region [ 17 ].…”