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Applied Health Economics and Health Policy

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01-04-2016 | Systematic Review

The Cost Effectiveness of High-Dose versus Conventional Haemodialysis: a Systematic Review

Authors: S. Laplante, F. X. Liu, B. Culleton, A. Bernardo, Denise King, P. Hudson

Published in: Applied Health Economics and Health Policy | Issue 2/2016

Abstract

Background

End-stage renal disease (ESRD) is fatal if untreated. In the absence of transplant, approximately 50 % of dialysis patients die within 5 years. Although more frequent and/or longer haemodialysis (high-dose HD) improves survival, this regimen may add to the burden on dialysis services and healthcare costs. This systematic review summarised the cost effectiveness of high-dose HD compared with conventional HD.

Methods

English language publications reporting the cost-utility/effectiveness of high-dose HD in adults with ESRD were identified via a search of MEDLINE, Embase, and the Cochrane Library. Publications comparing any form of high-dose HD with conventional HD were reviewed.

Results

Seven publications (published between 2003 and 2014) reporting cost-utility analyses from the public healthcare payer perspective were identified. High-dose HD in-centre was compared with in-centre conventional HD in one US model; all other analyses (UK, Canada) compared high-dose HD at home with in-centre conventional HD (n = 5) or in-centre/home conventional HD (n = 1). The time horizon varied from one year to lifetime. Similar survival for high-dose HD and conventional HD was assumed, with the impact of higher survival only assessed in the sensitivity analyses of three models. High-dose HD at home was found to be cost effective compared with conventional HD in all six analyses. The analysis comparing high-dose HD in-centre with conventional in-centre HD produced an incremental cost-effectiveness ratio generally acceptable for the USA, but not for Europe, Canada or Australia.

Conclusion

High-dose HD can be cost effective when performed at home. Future analyses assuming survival benefits for high-dose HD compared with conventional HD are needed.

Available only for authorised users

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Title: The Cost Effectiveness of High-Dose versus Conventional Haemodialysis: a Systematic Review
Authors: S. Laplante
F. X. Liu
B. Culleton
A. Bernardo
Denise King
P. Hudson
Publication date: 01-04-2016
Publisher: Springer International Publishing
Published in: Applied Health Economics and Health Policy / Issue 2/2016
Print ISSN: 1175-5652
Electronic ISSN: 1179-1896
DOI: https://doi.org/10.1007/s40258-015-0212-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Cost Effectiveness of High-Dose versus Conventional Haemodialysis: a Systematic Review

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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