Gaining Efficiencies: Resources and Demand for Dialysis around the Globe
Article first published online: 1 AUG 2008
© 2008, International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
Value in Health
Volume 12, Issue 1, pages 73–79, January/February 2009
How to Cite
Neil, N., Walker, D. R., Sesso, R., Blackburn, J. C., Tschosik, E. A., Sciaraffia, V., García-Contreras, F., Capsa, D. and Bhattacharyya, S. K. (2009), Gaining Efficiencies: Resources and Demand for Dialysis around the Globe. Value in Health, 12: 73–79. doi: 10.1111/j.1524-4733.2008.00414.x
- Issue published online: 23 JAN 2009
- Article first published online: 1 AUG 2008
- chronic kidney disease;
- end-stage renal disease;
- modality selection;
- peritoneal dialysis
Objectives: End-stage renal disease (ESRD) is a debilitating condition resulting in death unless treated. Treatment options are transplantation and dialysis. Alternative dialysis modalities are peritoneal dialysis (PD) and hemodialysis (HD), each of which has been shown to produce similar outcomes and survival. Nevertheless, the financial implications of each modality are different and these differences vary by country, especially in the developing world. Changes in clinically appropriate dialysis delivery leading to more efficient use of resources would increase the resources available to treat ESRD or other disabling conditions. This article outlines the relative advantages of HD and PD and uses budget impact analysis to estimate the country-specific, 5-year financial implications on total dialysis costs assuming utilization shifts from HD to PD in two high-income (UK, Singapore), three upper-middle-income (Mexico, Chile, Romania), and three lower-middle-income (Thailand, China, Colombia) countries.
Results: Peritoneal dialysis is a clinically effective dialysis option that can be significantly cost-saving compared to HD, even in developing countries.
Conclusions: The magnitude of costs associated with treating ESRD patients globally is large and growing. PD is a clinically effective dialysis option that can be used by a majority of ESRD patients and can also be significantly cost-saving compared to HD therapy. Increasing clinically appropriate PD use would substantially reduce health-care costs and help health-care systems meet ever-tightening budget constraints.