Economic evaluation of End Stage Renal Disease treatments in Iran
| Autor: | Mohamad Hadian, Amirali Moradpour, Mahmoud Tavakkoli |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Cost–utility analysis 030219 obstetrics & reproductive medicine Epidemiology business.industry medicine.medical_treatment Public Health Environmental and Occupational Health medicine.disease Peritoneal dialysis End stage renal disease Transplantation 03 medical and health sciences Indirect costs 0302 clinical medicine Infectious Diseases Economic evaluation medicine 030212 general & internal medicine Hemodialysis Intensive care medicine business health care economics and organizations Kidney transplantation |
| Zdroj: | Clinical Epidemiology and Global Health. 8:199-204 |
| ISSN: | 2213-3984 |
| DOI: | 10.1016/j.cegh.2019.07.001 |
| Popis: | Background End-stage Renal Disease is considered a health problem due to the high prevalence and economic burden on society and the health system. This study utilizes a cost-utility analysis to evaluate the costs and outcomes of the Iranian End Stage Renal Disease patients. Methods A Markov model-based economic evaluation with a societal perspective, and a lifetime horizon performed to quantify the costs and health-related outcomes in terms of QALY. Direct medical costs obtained from hospital billing and medical records and direct non-medical costs, and indirect costs derived from interviews with patients. Three policy options, the hemodialysis, peritoneal dialysis and kidney transplantation were compared. Most of the Transplants from deceased and rest were from Live Related Donors. One-way and probabilistic sensitivity analyses were performed to study uncertainty. Results Annual average cost of hemodialysis is $13477 cost of peritoneal dialysis is $12865, and cost of Transplantation is $16450.The Transplantation arm gained 9.43 QALY compared with peritoneal dialysis and hemodialysis with 6.95 and 6.04 QALY respectively. When Transplantation was compared with peritoneal dialysis, Incremental Cost-Effectiveness Ratio was $1744 per QALY. ICER value suggests that Transplantation is cost-effective compared with peritoneal dialysis at a willingness-to-pay threshold of $12,400, and hemodialysis was dominated. Conclusion This study suggests that kidney transplantation is a better option over hemodialysis and peritoneal dialysis. We conclude that serious efforts ought to be made to foster potential brain-dead donors and altruistic kidney donation and promote peritoneal dialysis as a superior alternative to hemodialysis for eligible patients. |
| Databáze: | OpenAIRE |
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