A societal cost-of-illness study of hemodialysis in Lebanon

Abstract

Hemodialysis represents a high societal burden in Lebanon. Using extrapolation, its total annual cost for the Lebanese society is estimated at $61,105,374 and the mean total annual cost ($18,516.7) is 43.70% higher than the gross domestic product per capita forecast for 2015. Measures to reduce the economic burden of hemodialysis should be taken, by promoting chronic kidney disease's prevention and encouraging transplantation.

Dialysis: the best quality at the lowest cost

“…Encouraging other modalities of renal replacement therapy in end-stage renal-disease patients is another way to reduce the costs and offer a good quality-of-life. Rizk et al 3 pointed out in their conclusion the high economic burden of HD. They rightly mentioned that transplantation and home HD could be two alternative cost-effective treatments based on previous international studies.…”

“…This issue of The Journal of Medical Economics includes a study by Rizk et al 3 that addresses the cost-of-illness of HD in Lebanon. Lebanon is a developing upper middle-income country of the middle-east area, with a total population estimated at 4.5 million people and a GNI per capita of $10,030 based on the World Bank 2014 4 .…”

“…It had 3,500 patients on dialysis in 2015, and this is the first time that the cost-of-illness of HD in Lebanon is reported. Rizk et al 3 took a sample of 119 patients from six out of 65 Lebanese dialysis facilities in 2011 and estimated the societal costs for each HD patient for 6 months at $9,258 (annually $18,516). They included in the cost the reimbursement fee provided by third payers in 2011 ($6,632 for 6 months) and they added the rate of hospitalizations, the medications ($1,640 annually for erythropoietin that is already a part of the reimbursed amount by MOPH), the travel, productivity losses, healthcare professionals, and professional home care.…”

“…This raised the annually reimbursed fee of HD per patient (if dialyzed three times per week) from $15,340 to $19,916. If we add the costs estimated by Rizk et al 3 such as costs of hospitalizations, outpatient consultations, productivity losses, and intravenous drugs (excluding the duplicate cost of erythropoietin), the total cost-of-illness of HD per patient per year reaches $21,300.…”

“…In summary, the initiative taken by Rizk et al 3 of estimating for the first time the cost-of-illness of HD in Lebanon is very useful and thoroughly detailed. Their analysis, however, targeted a small number of centers in the era before the implementation of ultrapure water and the increase in the reimbursement of HD.…”