Cost of Dialysis Therapy by Modality in Manitoba

Beaudry, Alain; Ferguson, Thomas; Rigatto, Claudio; Tangri, Navdeep; Dumanski, Sandra M.; Komenda, Paul

doi:10.2215/cjn.10180917

Cited by 63 publications

(87 citation statements)

References 35 publications

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“…HD provided at a tertiary care center or outpatient clinic is the most expensive, costing on average over $60,000 CAD per patient, per year when delivered thrice weekly (conventional) and even higher when delivered in shorter sessions daily or in longer sessions nocturnally (intensive). In contrast, self-care HD or PD performed in the home costs significantly less, between J o u r n a l P r e -p r o o f $35,000 and $45,000 CAD per year 5 . In addition, patients receiving dialysis may undergo multiple vascular access procedures and suffer from complications, including increased risk of infections, cardiovascular events, and hospitalizations, increasing the total cost of providing treatment for kidney failure 6 .…”

Section: Introductionmentioning

confidence: 91%

“…Maintenance costs for dialysis access were taken from a Canadian costing study 17 . Capital costs were taken from a Canadian study which estimated annual dialysis costs in Manitoba 5 . Costs related to transplantation (procedure, workup, donor-related expenses, and maintenance therapy) were estimated from a Canadian analysis of donor and recipient-related costs for both living and deceased donor transplantation 18 .…”

Section: Data Sources and Model Inputsmentioning

confidence: 99%

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Cost-Utility of Dialysis in Canada: Hemodialysis, Peritoneal Dialysis, and Nondialysis Treatment of Kidney Failure

et al. 2021

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Rationale & Objective The kidney failure population is growing, necessitating the expansion of dialysis programs. These programs are costly and require a substantial amount of health care resources. Tools that accurately forecast resource use can aid efficient allocation. The objective of this study is to describe the development of an economic simulation model that incorporates treatment history and detailed modality transitions for patients with kidney disease using real-world data to estimate associated costs, utility, and survival by initiating modality. Study Design Cost-utility model with microsimulation. Setting & Population Adult incident maintenance dialysis patients in Canada who initiated facility-based hemodialysis (HD) or home peritoneal dialysis (PD) between 2004 and 2013. Intervention HD and PD. Outcomes Costs (related to dialysis, transplantation, infections, and hospitalizations), survival, utility, and dialysis modality mix over time. Model, Perspective, & Timeframe The model took the perspective of the health care payer. Patients were followed up for 10 years from initiation of dialysis. Our cost-utility analysis compared the intervention with receiving no treatment. Results During a 10-year time horizon, the cost-utility ratio for all patients initiating dialysis was $103,779 per quality-adjusted life-year (QALY) in comparison to no treatment. Patients who initiated with facility-based HD were treated at a cost-utility ratio of $104,880/QALY and patients who initiated with home PD were treated at a cost-utility ratio of $83,762/QALY. During this time horizon, the total mean cost and QALYs per patient were estimated at $350,774 ± $204,704 and 3.38 ± 2.05) QALYs respectively. Limitations The results do not include costs from the societal perspective. Rare patient trajectories were unable to be assessed. Conclusions This model demonstrates that patients who initiated dialysis with PD were treated more cost-effectively than those who initiated with HD during a 10-year time horizon.

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Section: Introductionmentioning

confidence: 91%

Section: Data Sources and Model Inputsmentioning

confidence: 99%

Cost-Utility of Dialysis in Canada: Hemodialysis, Peritoneal Dialysis, and Nondialysis Treatment of Kidney Failure

et al. 2021

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“…In general, patients receiving haemodialysis (HD) incurred higher costs compared to patients managed by PD. Concerning place of dialysis delivery, HHD costs were 49-65% of ICHD costs [38,40,44]. Furthermore, 11 studies estimated the annual health care costs of KTx in the range of $14,067 to $80,876 (Table 3).…”

Section: Costs Of Different Treatment Modalities For Esrdmentioning

confidence: 99%

The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review

et al. 2020

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Chronic kidney disease (CKD) affects over 10% of the global population and poses significant challenges for societies and health care systems worldwide. To illustrate these challenges and inform cost-effectiveness analyses, we undertook a comprehensive systematic scoping review that explored costs, health-related quality of life (HRQoL) and life expectancy (LE) amongst individuals with CKD. Costs were examined from a health system and societal perspective, and HRQoL was assessed from a societal and patient perspective. Papers published in English from 2015 onward found through a systematic search strategy formed the basis of the review. All costs were adjusted for inflation and expressed in US$ after correcting for purchasing power parity. From the health system perspective, progression from CKD stages 1-2 to CKD stages 3a-3b was associated with a 1.1-1.7 fold increase in per patient mean annual health care cost. The progression from CKD stage 3 to CKD stages 4-5 was associated with a 1.3-4.2 fold increase in costs, with the highest costs associated with end-stage renal disease at $20,110 to $100,593 per patient. Mean EuroQol-5D index scores ranged from 0.80 to 0.86 for CKD stages 1-3, and decreased to 0.73-0.79 for CKD stages 4-5. For treatment with renal replacement therapy, transplant recipients incurred lower costs and demonstrated higher HRQoL scores with longer LE compared to dialysis patients. The study has provided a comprehensive updated overview of the burden associated with different CKD stages and renal replacement therapy modalities across developed countries. These data will be useful for the assessment of new renal services/ therapies in terms of cost-effectiveness.

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“…This type of treatment can be burdensome for patients and their support networks, as well as costly for healthcare payers and patients. In comparison, dialysis offered in the home setting, such as home hemodialysis (HHD), is a more cost‐effective treatment option in the long term . Furthermore, HHD provides patients with the ability to dialyze more frequently and/or for longer periods of time on a flexible schedule, which is generally associated with improved outcomes over traditional thrice‐weekly in‐center dialysis regimens, and may also be associated with lower rates of dialysis‐related complications, hospitalizations, and mortality .…”

Section: Introductionmentioning

confidence: 99%

“…In comparison, dialysis offered in the home setting, such as home hemodialysis (HHD), is a more cost-effective treatment option in the long term. 2,3 Furthermore, HHD provides patients with the ability to dialyze more frequently and/or for longer periods of time on a flexible schedule, which is generally associated with improved outcomes over traditional thrice-weekly in-center dialysis regimens, 4 and may also be associated with lower rates of dialysis-related complications, hospitalizations, and mortality. 5,6 Moreover, HHD also provides patients with greater autonomy and flexibility, allowing them to maintain a normal schedule without frequent dialysis facility or hospital visits, while also offering potential quality of life improvements.…”

Section: Introductionmentioning

confidence: 99%

Human factors testing of the Quanta SC+ hemodialysis system: An innovative system for home and clinic use

Harasemiw

Day

Milad³

et al. 2019

Hemodialysis International

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Introduction: Uptake rates of home hemodialysis are the lowest among all modality types, despite providing patients with clinical and quality of life benefits at a lower cost to providers. Currently, there is a need to develop dialysis systems that are appealing to patients while also being suitable for use across the continuum of care. The SC+ hemodialysis system was developed by Quanta Dialysis Technologies Ltd. to provide patients with a dialysis system that is small, simple to use, and powerful enough to deliver acceptable dialysis adequacy. Methods: As part of the SC+ design validation, human factors testing was performed with 17 Healthcare Professionals (nephrology nurses and healthcare assistants) and 15 Home Users (patients and caregivers). To assess usability and safety, the human factors testing involved between 4.5 and 6 hours of training and, after a period of training decay, a subsequent test session in which participants independently performed tasks on SC+. Findings: Between the two user groups, there were only 29 errors observed out of 1216 opportunities for errors, despite minimal training. Errors that did occur were minor and attributed to an initial lack of familiarity with the device; none were safety related. Discussion: Among prevalent dialysis patients and healthcare professionals, the SC+ hemodialysis system was easy to use, even with minimal training and a learning decay period, and had a high level of use safety. By taking into account human factors to optimize the user experience, SC+ has the potential to address systemic and patient barriers, allowing for wider self‐care and home hemodialysis adoption.

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Cost of Dialysis Therapy by Modality in Manitoba

Abstract: This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2018_07_18_CJASNPodcast_18_8_F.mp3.

Cited by 63 publications

References 35 publications

Cost-Utility of Dialysis in Canada: Hemodialysis, Peritoneal Dialysis, and Nondialysis Treatment of Kidney Failure

Cost-Utility of Dialysis in Canada: Hemodialysis, Peritoneal Dialysis, and Nondialysis Treatment of Kidney Failure

The impact of chronic kidney disease on developed countries from a health economics perspective: A systematic scoping review

Human factors testing of the Quanta SC+ hemodialysis system: An innovative system for home and clinic use

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