Comparison of hemodialysis and peritoneal dialysis--a cost-utility analysis.
OBJECTIVE
Our aim was to compare both health-related quality of life and costs for hemodialysis (HD) and peritoneal dialysis (PD) in a defined population.


METHODS
Decision-tree modeling to estimate total costs and effects for two treatment strategies, HD and PD, among patients with chronic kidney failure, for 5 years following the start of treatment. Courses of events and health-care consumption were mapped in a retrospective matched-record study. Data on health status were obtained from a matched population by a quality-of-life questionnaire (EuroQol). The study has a societal perspective.


METHODS
All dialysis departments in the southeastern health-care region of Sweden.


METHODS
136 patients with kidney failure, comprising 68 matched pairs, were included in a retrospective record study; 81 patients with kidney failure, comprising 27 matched triplets, were included in a prospective questionnaire study.


METHODS
Cost per life year and cost per quality-adjusted life year.


RESULTS
The cost per quality-adjusted life year for PD was lower in all analyzed age groups. There was a 12% difference in the age group 21-40 years, a 31% difference in the age group 41-60 years, and an 11% difference in the age group 61+ years. Peritoneal dialysis and HD resulted in similar frequencies of transplantation (50% and 41%, respectively) and expected survival (3.58 years and 3.56 years, respectively) during the first 5 years after the initiation of treatment.


CONCLUSIONS
The cost-utility ratio is most favorable for PD as the primary method of treatment for patients eligible for both PD and HD.
Sennfält
Karin
K
Center for Medical Technology Assessment, Linköping University, Sweden. karin.sennfalt@ihm.liu.se
Magnusson
Martin
M
Carlsson
Per
P
D003362:Cost-Benefit Analysis; D003663:Decision Trees; D017048:Health Care Costs; D006801:Humans; D007676:Kidney Failure, Chronic / Q000191:economics / Q000628:therapy*; D008875:Middle Aged; D018803:Models, Economic; D010530:Peritoneal Dialysis / Q000191:economics*; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D006435:Renal Dialysis / Q000191:economics*; D012189:Retrospective Studies