3 research outputs found
Economic impact of extended time on peritoneal dialysis as a result of using polyglucose: the application of a Markov chain model to forecast changes in the development of the ESRD programme over time
BACKGROUND: The use of polyglucose as a peritoneal dialysis (PD) fluid
extends time on PD treatment. It is anticipated, therefore, that the share
of patients treated with PD will be positively influenced. The
relationship between extension of PD treatment time and an increase of the
PD treatment share, however, is complex and needs further investigation.
In this paper, a Markov chain model was applied to investigate the impact
of extended time on PD treatment for the PD share in all dialysis patients
in The Netherlands. Furthermore, the economic impact of the extended time
on treatment (ETOT) was explored. METHODS: Scenarios were forecast over a
10 year period using aggregate data from the End-Stage Renal Registry in
The Netherlands (Renine). Three scenarios were simulated in which the
median PD technique survival was extended by 8, 10 and 12 months. Two
other scenarios explored the impact of the combined effect of ETOT of 10
months together with a 10% and 20% increase of PD inflow shares.
Reductions of costs to society due to ETOT were estimated using Dutch cost
data on renal replacement therapies. RESULTS: PD share increases from
30.0% in the null scenario to 34.5% in the scenario with an ETOT of 10
months and an increased PD inflow share of 20%. The reduction in total
costs to society of the renal replacement therapies is 0.96%. The average
societal costs per discounted patient year for haemodialysis (HD) are 84
100 euros. For PD, these costs are 60 300 euros. A shift from HD to PD
results in average cost savings of 28% per patient year. CONCLUSIONS: In
view of high dialysis costs to society, a reduction of 0.96% can be
considered to be relevant for healthcare policy makers