Abstract
Objective: Renal replacement therapy (RRT) is essential for maintenance of life for those with end-stage renal disease. However, there remain many areas of uncertainty about which method of RRT should be chosen. This paper reports an economic model based on a systematic review that attempts to determine which method of dialysis, continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis, a patient should have as the initial method of RRT.
Methods: A systematic review and a costing exercise carried out in a Scottish hospital were used to populate a Markov model. Scenario analysis was used to model plausible variations in variables included in the model.
Results: In 8 of the 16 scenarios developed hemodialysis dominated CAPD. In a further eight scenarios, the cost per life-year displayed considerable variability, ranging from between pound5,000 to pound 51,000. The higher costs per life-year were associated with minimum estimates of additional survival for a patient starting RRT on hospital hemodialysis.
Conclusion: It may be more cost-effective to manage patients starting on RRT with hospital hemodialysis than CAPD. This has particular implications for the United Kingdom, given that up to 50% of new patients receive CAPD.
Original language | English |
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Pages (from-to) | 181-189 |
Number of pages | 8 |
Journal | International Journal of Technology Assessment in Health Care |
Volume | 17 |
Issue number | 2 |
DOIs | |
Publication status | Published - 2001 |
Keywords
- cost-effectiveness
- hemodialysis
- CAPD
- Markov modeling
- systematic review
- AMBULATORY PERITONEAL-DIALYSIS
- HEMODIALYSIS