Economic evaluation of end stage renal disease patients undergoing hemodialysis

Abstract

Background:In India the incidence of end stage renal disease (ESRD) is increasing day by day and the option for the treatment of ESRD is dialysis or transplantation. In the present scenario, due to the cost of treatment normal people can afford only hemodialysis rather than transplantation. Since the cost of hemodialysis differs across the country, research is needed to evaluate its exact cost.Aim:This study is to analyze the healthcare cost of hemodialysis in a private hospital of South India.Materials and Methods:This is a prospective, observational study carried out in a tertiary care hospital. Patients who are undergoing routine hemodialysis in this hospital were selected for the study. Patient data as well as cost details were collected for a period of six months. Thirty patients were selected for the study and a total of 2160 dialysis sessions were studied. Patient perspective was taken for the analysis of cost. Both direct and indirect costs were analyzed. This includes cost of dialysis, investigations, erythropoietin, food, transportation, lost wages etc. Socioeconomic status of the patient was also studied.Result:The total cost per session was found to be around Rs. 4500. Fifty six percent contributes direct medical cost whereas 20% contributes direct non medical cost. Twenty four percent cost was due to indirect costs. Since the patients are paying from their own pocket, only the upper or upper middle class patient can undergo hemodialysis regularly.Conclusion:These findings are important to find out the impact of cost of hemodialysis on patients suffering from ESRD. Further studies related to costs and outcome, otherwise known as pharmacoeconomic studies, are needed to analyze the pros and cons of renal replacement therapy and to improve the quality of life of ESRD patients. Thus pharmacoeconomical studies are needed to realize that government has to take initiative to provide insurance or reimbursement for the common people.

The cost of dialysis in low and middle-income countries: a systematic review

“…Our analysis found three studies on the costs of dialysis in India. Suja et al [ 31 ] performed economic evaluation of ESRD patients undergoing HD at Amrita Institute of Medical Sciences, Kerala. Patient perspective was taken for the analysis of cost component and the details were collected by direct patient interview.…”

Estimation of quality of life in haemodialysis patients

“…These findings were consistent with other studies in which they found a positive correlation between income, employment and educational status. Financial constraints were less for upper and upper middle family that might be the major contributing factor for higher scores[23]. The higher educational status helps the patients to understand their illness in a better way and also about the importance of adherence to therapy.…”

A societal cost-of-illness study of hemodialysis in Lebanon

“…Although this cost component has been rarely assessed in COI studies on HD, the proportion found in this study is greatly lower than what was reported from other countries. [21,22,36,37] Beside differences in measurement and valuation methods, this finding might be attributed to the fact that 82.5% of the patients in our study were already unemployed or retired at the time of the analysis. Moreover, being prevalent patients, they already adapted their work schedules and daily life activities to their HD treatment, and the majority of them eventually managed to avoid losing additional hours of work or daily life activities due to their illness and its treatment.…”