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Economic evaluation of three dialysis methods in patients with end-stage renal disease in China

  • Nephrology - Original Paper
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Abstract

Objectives

End-stage renal disease (ESRD) may result in different degrees of physical and psychological pain. Automated peritoneal dialysis (APD), continuous ambulatory peritoneal dialysis (CAPD), and hemodialysis (HD) as the main treatment methods lead to a heavy burden on social economic and family financial. However, there are few studies on the economic evaluation of the three dialysis methods in China.

Methods

Cost-effectiveness analyses were performed using Markov models based on longitudinal data for 15 years of different modalities in Kunshan City, China. Direct cost derived from medical insurance information system, and indirect cost referred to as loss of productivity. Sensitivity analyses were conducted to study uncertainty.

Results

The per capita total cost of CAPD was 664,027.00 yuan, the per capita utility is 5.9105. The per capita total cost of APD was 858,800.65 yuan, the per capita utility is 6.4548. The per capita total cost of HD was 1,281,213.64 yuan, the per capita utility is 6.1356. When CAPD was compared with HD, Incremental Cost-Effectiveness Ratio (ICER) was 1,323,389.53 yuan per QALY, compared with APD, ICER was 357,848.13 yuan per QALY. ICER value suggests that APD was cost-effective compared with CAPD and HD at a willingness-to-pay threshold of 538,200 yuan.

Conclusion

Our research showed that APD is the most appropriate and HD is the worst in terms of cost-effectiveness. However, in fact, HD accounts for a high proportion in China, so some relevant policy suggestions need to be implemented to change the current situation.

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Acknowledgements

We are grateful to Prof. Jun Lu (Fudan University, School of Public Health) for commenting on an earlier version of this manuscript. We thanks Ye Zhuang for providing data support. In addition, we highly acknowledge Qi Zhang (Old Dominion University) for supporting our work.

Funding

This work was supported by National Social Science Foundation of China (17ZDA078) and the Scientific Research Project of Jiangsu Provincial Health Commission (H2017073).

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Author notes

  1. Zhuang Hong and Ye Zhuang contributed equally to this paper.

Authors and Affiliations

  1. School of Public Health, Fudan University, 130 Dong’an Road, Xuhui District, Shanghai, 200032, China

    Zhuang Hong, Ye Zhuang, Jun Lu & Heqi Sun

  2. Department of Nephrology, The First People’s Hospital of Kunshan, No. 91 West Qian-Jin Road, Kunshan, Suzhou, 215300, China

    Jianming Ye, Lanying Gao & Yan Xiong

Authors
  1. Zhuang Hong
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  2. Ye Zhuang
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  3. Jun Lu
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  5. Heqi Sun
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  6. Lanying Gao
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  7. Yan Xiong
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Contributions

All authors made substantial contributions to this study. ZH drafted the manuscript. JL provided important guidance on the writing and made great contributions in the process of revising. YZ conceived the idea. JY participated in the statistical collecting and data processing. HS, LG and YX provided relevant suggestions. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jun Lu or Jianming Ye.

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Conflicts of interest

The authors declare that they have no conflict of interest.

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Academic Research Ethics Committee of Fudan University School of Public Health confirmed this form of consent and approved the study protocol.

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The verbal informed consent was obtained from each participant prior to the survey.

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Hong, Z., Zhuang, Y., Lu, J. et al. Economic evaluation of three dialysis methods in patients with end-stage renal disease in China. Int Urol Nephrol 55, 1247–1254 (2023). https://doi.org/10.1007/s11255-022-03402-2

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  • DOI: https://doi.org/10.1007/s11255-022-03402-2

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