Costs of dialysis--a regional population-based analysis

Icks, Andrea; Haastert, Burkhard; Gandjour, Afschin; Chernyak, Nadja; Rathmann, Wolfgang; Giani, Guido; Rump, L. C.; Trapp, Rudolf; Koch, Michael

doi:10.1093/ndt/gfp672

Cited by 62 publications

(55 citation statements)

References 12 publications

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“…In the US in 2006, the mean annual cost of peritoneal dialysis was $53,000 per patient and haemodialysis was $72,000 per patient [22]. In a German study [23] the mean total dialysis-related costs were €55,000 per patient in 2006, with 55% accounting for dialysis procedures and 22% dialysis-related medications. Our study also showed that medications associated with renal failure incur the highest costs of outpatient prescription medications in type 1 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Cumulative cost of prescription medication in outpatients with type 1 diabetes in Finland

2010

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Aims/hypothesis We examined the 11-year cumulative outpatient cost of prescription medication in patients with type 1 diabetes by subgroups according to the presence of complications and duration of diabetes. Methods This longitudinal study included a nationally representative cohort of patients with type 1 diabetes (N=3,717) from the Finnish Diabetic Nephropathy Study (FinnDiane). The data were linked to the Drug Prescription Register. The cumulative cost was calculated between 1998 and 2008. Information on complications was updated until 2008. Patients were divided into 10-year groups according to the duration of diabetes in 1998. Generalised linear mixed models under gamma distribution were used to evaluate the costs. Results Approximately 25% of the patients had macrovascular disease (MVD) and/or end-stage renal disease (ESRD). The adjusted cumulative cost of medications increased 56% when MVD was present compared with those without complications. In patients with ESRD or with both complications present the cost increased fourfold or 15-fold, respectively, when diabetes medications were excluded. The proportion of renal failure related medications (immunosuppressants, peritoneal dialytics and erythropoietin) accounted for more than 70% of these costs. The cost of diabetes medication was rather stable, irrespective of complication status or duration of diabetes. However, when complications were present these costs were markedly lower in all 10-year duration groups. Conclusions/interpretation This study shows that ESRD has a great impact on outpatient prescription medication costs. Since no considerable differences were observed in the cost of diabetes medication, the increase was completely due to the cost of medications related to comorbidity.

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Section: Discussionmentioning

confidence: 99%

Cumulative cost of prescription medication in outpatients with type 1 diabetes in Finland

2010

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“…Patients are usually faced with this decision more than once in their life, as patients frequently require switching between certain modalities for a variety of reasons [46]. This makes it particularly difficult to track costs accurately as the cost drivers come from different sources and are provided by different healthcare professionals [47]. Applying Porter's model to a CKD patient would entail to track meaningful disease-specific costs from a patient entering CKD stage 3 until death [48].…”

Section: Measure Costs Meaningful To Health Systemsmentioning

confidence: 99%

Chronic Kidney Disease: Exploring Value-Based Healthcare as a Potential Viable Solution

et al. 2019

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Background: Increasing healthcare expenditures have triggered a trend from volume to value by linking patient outcome to costs. This concept first described as value-based healthcare (VBHC) by Michael Porter is especially applicable for chronic conditions. This article aims to explore the applicability of the VBHC framework to the chronic kidney disease (CKD) care area. Methods: The 4 dimensions of VBHC (measure value; set and communicate value benchmarking; coordinate care; payment to reward value-add) were explored for the CKD care area. Available data was reviewed focusing on CKD initiatives in Europe to assess to what extent each of the 4 dimensions of VBHC have been applied in practice. Results: Translating VBHC into value-based renal care (VBRC) seems to be initiated to a limited extent in European health systems. In most cases not all dimensions of VBHC have been utilized in the renal care initiatives. Conclusion: The translation of VBHC into VBRC is possible and even desirable if an optimal treatment pathway for CKD patients could be achieved. This would require an organizational change in health system set up and should include a strategy focusing on full care responsibility. The patient outcome perspective and health economic analysis need to be the centre of attention.

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“…Ebenfalls in den USA wurde im Zeitraum 1975 bis 1990 für Männer ein relatives Risiko für eine Niereninsuffizienz von 12,7 bei Diabetes im Vergleich zu Nicht-Diabetes geschätzt [3]. Auch in einer aktuellen Analyse auf der Basis regionaler Dialysezentren waren fast 50% der inzidenten Patienten mit Nierenersatztherapie diabetisch [19]. Erste Ergebnisse der Analyse der Inzidenzen der terminalen Niereninsuffizienzen in der diabetischen und der nichtdiabetischen Population lassen vermuten, dass das relative Risiko für eine Nierenersatztherapie bei Diabetes gegenüber nichtdiabetischen Patienten etwas niedriger liegt als in den USA gefunden.…”

Section: Tab 1 Relative Risiken Der Diabetischen Spätschäden (Nach unclassified

Late diabetic complications

Icks

2010

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Costs of dialysis--a regional population-based analysis

Cited by 62 publications

References 12 publications

Cumulative cost of prescription medication in outpatients with type 1 diabetes in Finland

Cumulative cost of prescription medication in outpatients with type 1 diabetes in Finland

Chronic Kidney Disease: Exploring Value-Based Healthcare as a Potential Viable Solution

Late diabetic complications

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