Authors : Lonn E, Bosch J, Teo KK, Pais P, Xavier D, Yusuf S.
Publication Year : 2010
An economic evaluation of continuous ambulatory peritoneal dialysis (CAPD), home haemodialysis, incentre haemodialysis and transplantation was carried out using cost effectiveness analysis to evaluate the cost per life year saved. The probability that a person with end stage renal failure would change treatment modalities was used to calculate an average five year treatment profile. The present value of the cost per life year saved (expressed in 1988 $NZ) was $35,270 for incentre dialysis, $28,175 for home haemodialysis, $26,390 for continuous ambulatory peritoneal dialysis at Middlemore Hospital, $25,395 for continuous ambulatory peritoneal dialysis at Auckland Hospital and $18.463 for transplantation. This ranking was unchanged after various sensitivity analyses. This apparent ranking of the cost effectiveness of the different modalities cannot, however, be used to support a decrease in haemodialysis in favour of an increase in transplants and continuous ambulatory peritoneal dialysis until marginal cost factors have been studied. It must also be recognised that social and medical characteristics define which treatments are appropriate for any patient so that the different modalities are not perfect substitutes for each other.