Cost-effectiveness analysis of hemodialysis plus hemoperfusion versus hemodialysis alone in adult patients with end-stage renal disease in China
| Autor: | Wendi Cheng, Yuyan Fu, Mark Pennington, Chunlin Jin, Xin Liu, Gengru Jiang, Xiaoxiao Qin, Huajie Jin, Wei Lu, Haiyin Wang, Yashuang Luo |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Cost–utility analysis
medicine.medical_specialty business.industry medicine.medical_treatment Incidence (epidemiology) General Medicine Cost-effectiveness analysis Hemoperfusion End stage renal disease Clinical trial Internal medicine Multicenter trial medicine Original Article Hemodialysis business health care economics and organizations |
| Zdroj: | Ann Transl Med King's College London |
| ISSN: | 2305-5839 |
| Popis: | Background This study evaluates the cost-effectiveness of hemodialysis (HD) plus hemoperfusion (HP) with HD alone in adult patients with end-stage renal disease (ESRD) in China. Methods A Markov model was constructed to assess the cost-effectiveness of interventions over a lifetime horizon. Model parameters were informed by the HD/HP trial, the first randomized, open-label multicenter trial comparing survival outcomes and incidence of cardiovascular disease (CVD) for HD + HP versus HD alone, and supplemented by published literature and expert opinion. The primary outcome was the incremental cost-effectiveness ratio (ICER) with respect to quality adjusted life-years (QALY). The robustness of the results was examined in extensive sensitivity analyses. Analyses were conducted from a healthcare perspective. Costs were reported in both Chinese Renminbi (RMB) and US Dollars (USD) in 2019 values. Results The base case ICER of HD + HP is RMB 174,486 (USD 25,251) per QALY, which is lower than the RMB 212,676 (USD 30,778) willingness-to-pay threshold of three times Gross Domestic Product. This conclusion is sensitive to the mortality for patients with no severe CVD events, the incidence of CVD events, and the cost of HP and HD. At a willingness-to-pay threshold of RMB 212,676 (USD 30,778) per QALY gained, the probability that HD + HP is cost-effective is 58%. Conclusions Our results indicate a potential for HD + HP to be cost-effective for patients with ESRD. Further evidence on the longer-term impact of HD + HP on CVD event rates and mortality unrelated to CVD is needed to robustly demonstrate the cost-effectiveness of HD + HP. Trial registration The HD/HP trial was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-16009332). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|