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Intensive Care Medicine

, Volume 39, Issue 3, pp 406–413 | Cite as

Five-year cost-utility analysis of acute renal replacement therapy: a societal perspective

  • Annika LaukkanenEmail author
  • Linda Emaus
  • Ville Pettilä
  • Kirsi-Maija Kaukonen
Original

Abstract

Purpose

Assessment of the cost utility (CU) of acute renal replacement therapy (RRT) from a societal perspective during a 5-year follow-up.

Methods

This was a cross-sectional cohort study in a medical-surgical intensive care unit and an acute RRT unit of 410 consecutive patients treated with acute RRT in Helsinki University Hospital in 2000–2002. Five-year survival and health-related quality of life (HRQoL) were assessed and used to calculate quality-adjusted life years (QALYs) in two ways. They were first calculated for the 5-year follow-up period and, second, estimated for the expected lifetime. HRQoL was assessed by the EuroQol (EQ-5D) in 2003. The cost analysis included hospital costs during index hospitalization along with hospital and societal costs for the following 5 years. The CU ratio was determined as total costs divided by gained QALYs.

Results

Median survival time for all patients was 0.20 years and the EQ-5D index score was 0.68, 0.18 lower than that of the age- and gender-matched general population. All RRT-treated patients gained 0.10 QALYs/patient and hospital survivors 2.54 QALYs in 5 years. Overall the CU ratio was poor [5 year median 271,116 (29,782–2,177,581) €/QALY]. However, it was acceptable (less than 50,000 €/QALY) in patients who survived for more than a year and did not need chronic RRT. Cost utility decreased with increasing age exceeding 1.0 million €/QALY in the older groups.

Conclusions

In general, the CU ratio of acute RRT is poor. However, it is acceptable in patients with renal recovery who survive for more than 1 year.

Keywords

Cost-effectiveness Acute kidney injury Renal replacement therapy Quality of life Critical care Outcome 

Notes

Acknowledgments

We thank Prof. Seppo Sarna for his help in the statistical analysis.

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Copyright information

© Springer-Verlag Berlin Heidelberg and ESICM 2012

Authors and Affiliations

  • Annika Laukkanen
    • 1
    Email author
  • Linda Emaus
    • 1
  • Ville Pettilä
    • 1
  • Kirsi-Maija Kaukonen
    • 1
  1. 1.Intensive Care Unit, Division of Anaesthesiology and Intensive Care Medicine, Department of SurgeryHelsinki University Central HospitalHelsinkiFinland

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