Increasing home‐based dialysis therapies to tackle dialysis burden around the world: A position statement on dialysis economics from the 2nd Congress of the International Society for Hemodialysis

Li, Philip Kam-Tao; Cheung, Wai Lun; Lui, Sing Leung; Blagg, Christopher R.; Cass, Alan; Hooi, Lai Seong; Lee, Ho Yung; Locatelli, Francesco; Yang, Chih‐Wei; Canaud, Bernard; Cheng, Yuk Lun; Choong, Hui Lin; Francisco, Angel Lm De; Gura, Victor; Kaizu, Kazo; Kerr, Peter G.; Kuok, Un I; Leung, Chi Bon; Lo, Wai Kei; Misra, Madhukar; Szeto, Cheuk‐Chun; Tong, Kwok Lung; Tungsanga, Kriang; Walker, Robert; Wong, Andrew; Yu, Alan C. L.

doi:10.1111/j.1542-4758.2010.00512.x

Cited by 21 publications

(25 citation statements)

References 21 publications

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“…Over a lifetime horizon based on a simpler cost-minimization approach, the PD strategy was the most preferable first-line dialysis strategy from both healthcare provider and societal perspectives. This finding echoed previous costing analyses based on the context of Hong Kong [2], Asian-Pacific countries [26] and other developed countries [25,27]. By aggregating annual costs and effectiveness, hospital-based HD strategy accumulated the lowest total health effectiveness and high total costs, mainly attributable to expensive HD sessions in hospital setting.…”

Section: Health Utilitysupporting

confidence: 71%

Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

Wong

Chen

Fung³

et al. 2020

BMC Nephrol

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Background: This study aimed to determine the lifetime cost-effectiveness of first-line dialysis modalities for endstage renal disease (ESRD) patients under the "Peritoneal Dialysis First" policy. Methods: Lifetime cost-effectiveness analyses from both healthcare provider and societal perspectives were performed using Markov modelling by simulating at age 60. Empirical data on costs and health utility scores collected from our studies were combined with published data on health state transitions and survival data to estimate the lifetime cost, quality-adjusted life-years (QALYs) and cost-effectiveness of three competing dialysis modalities: peritoneal dialysis (PD), hospital-based haemodialysis (HD) and nocturnal home HD. Results: For cost-effectiveness analysis over a lifetime horizon from the perspective of healthcare provider, hospitalbased HD group (lifetime cost USD$142,389; 6.58 QALYs) was dominated by the PD group (USD$76,915; 7.13 QALYs). Home-based HD had the highest effectiveness (8.37 QALYs) but with higher cost (USD$97,917) than the PD group. The incremental cost-effectiveness ratio (ICER) was USD$16,934 per QALY gained for home-based HD over PD. From the societal perspective, the results were similar and the ICER was USD$1195 per QALY gained for homebased HD over PD. Both ICERs fell within the acceptable thresholds. Changes in model parameters via sensitivity analyses had a minimal impact on ICER values. Conclusions: This study assessed the cost-effectiveness of dialysis modalities and service delivery models for ESRD patients under "Peritoneal Dialysis First" policy. For both healthcare provider and societal perspectives, PD as firstline dialysis modality was cost-saving relative to hospital-based HD, supporting the existing PD First or favoured policy. When compared with PD, Nocturnal home Home-based HD was considered a cost-effective first-line dialysis modality for ESRD patients.

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Section: Health Utilitysupporting

confidence: 71%

Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

Wong

Chen

Fung³

et al. 2020

BMC Nephrol

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“…Benefits to patients include improved blood pressure control, liberalization of the diet, increased independence, improved quality of life and improved survival . Originally, the concept of home dialysis was put into practice in 1964 because of limited funds and today cost effectiveness advantages continue to be demonstrated . Despite potential benefits, various barriers to home dialysis have been reported .…”

Section: Discussionmentioning

confidence: 99%

Increasing home dialysis knowledge through a web‐based e‐learning program

et al. 2014

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“…Apart from the fact that PD is more tolerable in infants and young children, PD is more cost-effective compared to hemodialysis (HD). 1,2 In Indonesia, the annual costs of HD per patient may reach 12,000 USD, while the cost of PD is approximately 6,000 USD. Moreover, PD has more simple requirements in terms of medical personnel and facilities compared to HD.³ Therefore, the implementation of PD in developing countries can minimize the gap between demand and supply of renal replacement therapy (RRT) for children with end-stage renal disease (ESRD).…”

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confidence: 99%

Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

et al. 2019

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BACKGROUND The pediatric peritoneal dialysis (PD) program in Cipto Mangunkusumo Hospital, Indonesia was started in 2014. However, there has been no published data on the patients’ outcome. This study was aimed to report the characteristics and outcomes of a continuous ambulatory peritoneal dialysis (CAPD) program for children. METHODS This retrospective study was conducted in Cipto Mangunkusumo Hospital as a national referral hospital. Data were collected from medical records of patients aged ≤18 years with end-stage renal disease who underwent CAPD in 2014–2019. The baseline characteristics, PD-related infection rate, as well as patient and technique survivals were analyzed. RESULTS Out of 60 patients who underwent CAPD, 36 (60%) were boys on the age range of 4 months–18 years. The mean follow-up duration was 12 (95% confidence interval [CI] = 9.4–15.3) months. The number of PD related infections increased along with the growing number of patients on CAPD. The peritonitis rate was 0.42 episodes per year at risk, and the most common etiology was alpha-hemolytic Streptococcus (5/24, [20.8%]). The 1- and 3-year technique survival rates were 60.3% (95% CI = 44.5–72.9) and 43.9% (95% CI = 23.2–62.9). The 1- and 3-year patient survival rates were 69.6% (95% CI = 52.5–81.5) and 58% (95% CI = 31.2–77.5). CONCLUSIONS In this unit, CAPD could be performed in children as young as 4 months of age. The peritonitis rate was relatively low which was likely caused by skin-derived microorganisms. Both technique survival and patient survival were also relatively low.

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Increasing home‐based dialysis therapies to tackle dialysis burden around the world: A position statement on dialysis economics from the 2nd Congress of the International Society for Hemodialysis

Cited by 21 publications

References 21 publications

Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

Increasing home dialysis knowledge through a web‐based e‐learning program

Five-year experience of continuous ambulatory peritoneal dialysis in children: a single center experience in a developing country

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