The Cost Effectiveness of High-Dose versus Conventional Haemodialysis: a Systematic Review.
Appl Health Econ Health Policy
; 14(2): 185-93, 2016 Apr.
Article
em En
| MEDLINE
| ID: mdl-26691659
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fatores de Tempo
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Diálise Renal
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Análise Custo-Benefício
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Falência Renal Crônica
Tipo de estudo:
Health_economic_evaluation
/
Prognostic_studies
/
Systematic_reviews
Limite:
Adult
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Aged
/
Aged80
/
Female
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Humans
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Male
/
Middle aged
País como assunto:
America do norte
/
Europa
/
Oceania
Idioma:
En
Ano de publicação:
2016
Tipo de documento:
Article