Economic evaluation of peritoneal dialysis and hemodialysis in Thai population with End-stage Kidney Disease

Assanatham, Montira; Pattanaprateep, Oraluck; Chuasuwan, Anan; Vareesangthip, Kriengsak; Supasyndh, Ouppatham; Lumpaopong, Adisorn; Susantitaphong, Paweena; Limkunakul, Chutatip; Ponthongmak, Wanchana; Chaiyakittisopon, Kamolpat; Thakkinstian, Ammarin; Ingsathit, Atiporn

doi:10.1186/s12913-022-08827-0

Cited by 11 publications

(7 citation statements)

References 33 publications

(30 reference statements)

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“…They investigated the patients in a longer follow-up period, which might explain the discrepancies in our numbers. Researchers in Asian countries similarly calculated superior costutility of PD in their analyses [12]. The overall better cost-utility in their papers compared to ours or the one from Ferguson et al might be attributable to a generally lower cost level and especially lower wage costs in the respective countries.…”

Section: Discussionmentioning

confidence: 50%

Center Hemodialysis Versus Peritoneal Dialysis: A Cost-Utility Analysis

Matrisch,

Rau

2024

Cureus

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IntroductionKidney replacement therapy (KRT) is needed for patients with end-stage kidney disease. While it is clear that kidney transplantation remains the gold standard in KRT, data comparing the cost-utility of peritoneal dialysis (PD) and hemodialysis (HD) are scarce. No such analysis has been performed for German patients. MethodsWe used aggregated data generated by the Short Form 36 Health Survey (SF-36) for quality of life and insurance claims to evaluate mortality and economic impact. Quality-adjusted life years (QALY) and costutility were calculated accordingly. ResultsPD is superior to HD within all dimensions of the SF-36, both in terms of QALY and cost-utility. The difference in cost per QALY between the aggregated physical dimensions (€50,671.54 vs. €39,745.77) is greater than that of the aggregated mental dimensions (€31,638.75 vs. €25,287.63). However, there is considerable variability among patients. ConclusionFrom a health-economic point of view, PD should be preferred over HD when deciding on the KRT modality for the patient. This is not reflected in current practice, though. However, interindividual differences and patient preferences should be considered in the decision.

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Section: Discussionmentioning

confidence: 50%

Center Hemodialysis Versus Peritoneal Dialysis: A Cost-Utility Analysis

Matrisch,

Rau

2024

Cureus

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“…They concluded kidney transplantation is the most cost-effective strategy, followed by PD and HD. In another study in Thailand, PD was found to be more cost-effective compared to HD based on the current WTP threshold [ 29 ]. In a study by Putri et al in Indonesia [ 30 ], PD provided good value for money versus HD for ESRD patients based on cost analysis and QALYs gained.…”

Section: Discussionmentioning

confidence: 99%

Peritoneal dialysis vs. hemodialysis among patients with end-stage renal disease in Iran: which is more cost-effective?

Yousefi,

Rezaei,

Hajebrahimi

et al. 2024

BMC Nephrol

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Background There is little economic evidence on different modalities among patients with end-stage renal disease (ESRD) in Iran. This study aimed to assess the cost-utility of peritoneal dialysis (PD) and hemodialysis (HD) among ESRD patients in Iran. Methods From the health system perspective and with a 10-year time horizon, we conducted a cost-utility analysis based on a Markov model to compare three strategies of PD and HD [the second scenario (30% PD, 70% HD), the third scenario (50% PD, 50% HD) and the fourth scenario (70% PD, 30% HD)] among ESRD patients with the current situation (PD, 3% vs. HD, 97%) as the basic scenario (the first scenario) in Iran. Cost data for PD, HD and kidney transplantation were extracted from the medical records of 720 patients in the Health Insurance Organization (HIO) database. The Iranian version of the EQ-5D-5 L questionnaire was filled out through direct interview with 518 patients with ESRD to obtain health utility values. Other variables such as transition probabilities and survival rates were extracted from the literature. To examine the uncertainty in all variables included in the study, a probabilistic sensitivity analysis (PSA) was performed. TreeAge Pro 2020 software was used for data analysis. Findings : Our analysis indicated that the average 10-year costs associated with the first scenario (S1), the second scenario (S2), the third scenario (S3) and the fourth scenario (S4) were 4750.5, 4846.8, 4918.2, and 4989.6 million Iranian Rial (IRR), respectively. The corresponding average quality-adjusted life years (QALYs) per patient were 2.68, 2.72, 2.75 and 2.78, respectively. The ICER for S2, S3 and S4 scenarios was estimated at 2268.2, 2266.7 and 2266.7 per a QALY gained, respectively. The analysis showed that at a willingness-to-pay (WTP) threshold of 3,000,000,000 IRR (2.5 times the GDP per capita), the fourth scenario had a 63% probability of being cost-effective compared to the other scenarios. Conclusion Our study demonstrated that the fourth scenario (70% PD vs. 30% HD) compared to the current situation (3% PD vs. 97% HD) among patients with ESKD is cost-effective at a threshold of 2.5 times the GDP per capita (US$4100 in 2022). Despite the high cost of PD, due to its greater effectiveness, it is recommended that policymakers pursue a strategy to increase the use of PD among ESRD patients.

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“…Although previous studies reported an elevated risk of mortality of 24% to 70% with decreased kidney function ( 50 ), our finding showed much more modest risk, which may be due to the Universal Healthcare Coverage in Thailand which has been available since 2002, including peritoneal dialysis since 2008 ( 51 , 52 ). Subsidizing care improves treatment accessibility, reducing the mortality rate ( 53 – 55 ).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of transitions from early hypertension to hypertensive chronic kidney disease, coronary artery disease, stroke and mortality: a Thai real-world data cohort

Teza

Boonmanunt

Unwanatham

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveSystemic arterial hypertension (HT) is a major modifiable risk factor for cardiovascular disease (CVDs), associated with all-cause death (ACD). Understanding its progression from the early state to late complications should lead to more timely intensification of treatment. This study aimed to construct a real-world cohort profile of HT and to estimate transition probabilities from the uncomplicated state to any of these long-term complications; chronic kidney disease (CKD), coronary artery disease (CAD), stroke, and ACD.MethodsThis real-world cohort study used routine clinical practice data for all adult patients diagnosed with HT in the Ramathibodi Hospital, Thailand from 2010 to 2022. A multi-state model was developed based on the following: state 1-uncomplicated HT, 2-CKD, 3-CAD, 4-stroke, and 5-ACD. Transition probabilities were estimated using Kaplan-Meier method.ResultsA total of 144,149 patients were initially classified as having uncomplicated HT. The transition probabilities (95% CI) from the initial state to CKD, CAD, stroke, and ACD at 10-years were 19.6% (19.3%, 20.0%), 18.2% (17.9%, 18.6%), 7.4% (7.1%, 7.6%), and 1.7% (1.5%, 1.8%), respectively. Once in the intermediate-states of CKD, CAD, and stroke, 10-year transition probabilities to death were 7.5% (6.8%, 8.4%), 9.0% (8.2%, 9.9%), and 10.8% (9.3%, 12.5%).ConclusionsIn this 13-year cohort, CKD was observed as the most common complication, followed by CAD and stroke. Among these, stroke carried the highest risk of ACD, followed by CAD and CKD. These findings provide improved understanding of disease progression to guide appropriate prevention measures. Further investigations of prognostic factors and treatment effectiveness are warranted.

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Economic evaluation of peritoneal dialysis and hemodialysis in Thai population with End-stage Kidney Disease

Cited by 11 publications

References 33 publications

Center Hemodialysis Versus Peritoneal Dialysis: A Cost-Utility Analysis

Center Hemodialysis Versus Peritoneal Dialysis: A Cost-Utility Analysis

Peritoneal dialysis vs. hemodialysis among patients with end-stage renal disease in Iran: which is more cost-effective?

Evaluation of transitions from early hypertension to hypertensive chronic kidney disease, coronary artery disease, stroke and mortality: a Thai real-world data cohort

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