title: A comprehensive approach to assess the costs of renal replacement therapy for end-stage renal disease in France: the importance of age, diabetes status, and clinical events.
abstract: OBJECTIVE
  In the current pressured economic context, and to continue to treat the growing number of patients with high-quality standards, the first step is to have a better understanding of the costs related to end-stage renal disease (ESRD) treatment according to various renal replacement therapy, age, diabetes status, and clinical events.
  
  
  METHODS
  In order to estimate the direct costs of all adult ESRD patients, according to (RRT) modality, patient condition, and clinical events, data from the French national health insurance funds were used.
  
  
  RESULTS
  The mean monthly costs for the 47,862 stable prevalent patients (73 % of the population) varied substantially according to treatment modality (from 7300€ for in-center hemodialysis to 1100€ for a functioning renal graft) and to clinical event (8300€ for the first month of dialysis, 11,000€ for the last month before death, 22,800€ for the first month after renal transplantation). Mean monthly costs varied according to diabetic status and to age to a lesser extent.
  
  
  CONCLUSIONS
  These results demonstrate, for the first time in France and in Europe, the importance of a dynamic view of renal care and the bias likely when comparing treatments in cross-sectional studies.
authors.affiliation: Service évaluation économique et santé publique. Haute Autorité de Santé, 5 avenue du Stade de France, 93218, Saint-Denis La Plaine Cedex, France. al.couillerot@has-sante.fr.
authors.forename: Anne-Line
authors.initials: AL
authors.lastname: Couillerot-Peyrondet
authors.affiliation: Service évaluation économique et santé publique. Haute Autorité de Santé, 5 avenue du Stade de France, 93218, Saint-Denis La Plaine Cedex, France.
authors.forename: Cléa
authors.initials: C
authors.lastname: Sambuc
authors.affiliation: Pôle Organisation et Financement des Activités de Soins. Agence de la biomédecine, Saint-Denis La Plaine, France.
authors.forename: Yoël
authors.initials: Y
authors.lastname: Sainsaulieu
authors.affiliation: REIN registry. Agence de la biomédecine, Saint-Denis La Plaine, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Couchoud
authors.affiliation: Service évaluation économique et santé publique. Haute Autorité de Santé, 5 avenue du Stade de France, 93218, Saint-Denis La Plaine Cedex, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bongiovanni-Delarozière
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D017281:Cost of Illness; D016208:Databases, Factual; D003920:Diabetes Mellitus; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D007348:Insurance, Health; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017582:Renal Replacement Therapy / Q000191:economics*; D012307:Risk Factors; D055815:Young Adult
keywords: Age; Diabetes; End-stage renal disease; Renal replacement therapy; costs