A retrospective cohort study on the cost-effectiveness analysis of kidney transplantation compared to dialysis in Cameroon: evidence for policy.

Autor:	Njamnshi RK; Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, United States of America.; Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon., Maimouna M; Haemodialysis Unit, Yaoundé General Hospital, Yaoundé, Cameroon.; Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon., Ngarka L; Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon.; Neuroscience Laboratory, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon., Tomta AEN; Haemodialysis Unit, Yaoundé General Hospital, Yaoundé, Cameroon., Njamnshi WY; Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon.; Neuroscience Laboratory, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon.; Department of Clinical and Developmental Neuropsychology, University of Bournemouth, England, United Kingdom., Ashuntantang GE; Haemodialysis Unit, Yaoundé General Hospital, Yaoundé, Cameroon.; Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon., Djientcheu VPN; Clinical Neuroscience Division (Neurology-Neurosurgery), Yaoundé General Hospital, Yaoundé, Cameroon.; Department of Surgery and Specialties (Neurosurgery), Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon., Njamnshi AK; Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon.; Neuroscience Laboratory, Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Cameroon.; Clinical Neuroscience Division (Neurology-Neurosurgery), Yaoundé General Hospital, Yaoundé, Cameroon., Shepard DS; Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts, United States of America.
Jazyk:	angličtina
Zdroj:	The Pan African medical journal [Pan Afr Med J] 2023 Sep 18; Vol. 46, pp. 27. Date of Electronic Publication: 2023 Sep 18 (Print Publication: 2023).
DOI:	10.11604/pamj.2023.46.27.38706
Abstrakt:	Introduction: chronic kidney disease affects one in ten adults in Cameroon. Haemodialysis was the only renal replacement therapy (for adults) in Cameroon and its sub-region until November 10, 2021. Thereafter through May 2022, the Yaoundé General Hospital successfully completed four living-donor kidney transplants. This paper examines policy implications. Methods: medical records of cohorts of kidney failure patients who started haemodialysis at Yaoundé General Hospital in 2012 (n=106) and 2017 (n=118) were abstracted retrospectively through 2021 and their survival analyzed with Microsoft Excel and Kaplan-Meier curves. Using hospital data, the literature, and price indexes, the annual medical cost per patient of dialysis and living-donor kidney transplantation in 2022 prices was derived. Results: the 9.5-year survival rate for the 2012 cohort was 11% and the 5-year rate for the 2017 cohort was 18%. Annual haemodialysis cost per patient averaged $17,681 (26.5% from households and 73.5% from government). Initial transplantation costs averaged $10,530 per patient, all borne by the government. Under the brand-drug option, first-year transplantation follow-up costs $19,070 (4% for laboratory and 96% for drugs). Conclusion: annually, haemodialysis in Cameroon costs per patient 12 times the country's average income ($1,537), driven especially by the costs of equipment purchase, maintenance, and consumables. Cameroon's initial cost of transplantation is lower than in other African countries. Generic drugs could lower annual follow-up costs by 89%. If Cameroon could achieve long-term survival with generic drugs after kidney transplantation, that modality would become a reasonable option for selected kidney failure patients (e.g. younger and without other comorbidities). Competing Interests: The authors declare no competing interests. (Copyright: Rene Kanjo Njamnshi et al.)
Databáze:	MEDLINE
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