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Analysis of economic impact between the modality of renal replacement therapy
Denise Sbrissia E Silva Gouveia1, Alexandre Tortoza Bignelli2, Silvia Regina Hokazono2
1Hospital Nossa Senhora das Graças.
Insights
Kidney transplantation is more cost-effective than hemodialysis or peritoneal dialysis after two years of renal replacement therapy. This finding supports improved government policies for transplantation.
Area of Science:
- Nephrology
- Health Economics
- Public Health Policy
Background:
- Chronic kidney disease (CKD) significantly reduces life expectancy and increases cardiovascular disease risk.
- CKD management involves renal replacement therapies like dialysis and transplantation.
- Understanding the financial impact of different CKD treatments is crucial for healthcare systems.
Purpose of the Study:
- To evaluate the financial impact of kidney transplantation versus dialysis modalities.
- To compare the costs of hemodialysis, peritoneal dialysis, and kidney transplantation.
- To inform healthcare policy regarding renal replacement therapy in Brazil.
Main Methods:
- Observational, retrospective cohort study.
- Analysis of patient medical records in Curitiba, Brazil (January-June 2014).
- Inclusion of patients undergoing hemodialysis, peritoneal dialysis, and kidney transplantation.
Main Results:
- First-year kidney transplant costs ranged from R$ 40,743.03 (cyclosporine) to R$ 48,388.17 (tacrolimus).
- By the second year, kidney transplantation costs (R$ 67,023.39 with tacrolimus) were lower than hemodialysis (R$ 71,717.51) and automated peritoneal dialysis (R$ 69,527.03).
- Transplantation demonstrated a lower overall cost compared to dialysis after two years.
Conclusions:
- Kidney transplantation is a more cost-effective renal replacement therapy after the initial two years.
- Findings support policy improvements to promote kidney transplantation.
- Optimizing renal replacement therapy choices can reduce healthcare system costs.
Introduction:
Chronic kidney disease (CKD) is a major health problem, determining the reduction in life expectancy and an increased risk of cardiovascular disease.
Method:
An observational, cohort, retrospective, based on patient's medical records data with CKD under hemodialysis, peritoneal dialysis and kidney transplantation in the city of Curitiba, in the period from January to June 2014, evacuativo the financial impact on the Unified Health System (SUS) and the supplementary health.
Results:
The lowest cost of a kidney transplant in the first year was R$ 40,743.03 when cyclosporine was used and the highest was R$ 48,388.17 with the use of tacrolimus. In the second year post-transplant, hemodialysis and peritoneal dialysis have a higher cost compared to kidney transplant. Transplantation with deceased donor, treated with tacrolimus: R$ 67,023.39; Hemodialysis R$ 71,717.51 and automated peritoneal dialysis automatic R$ 69,527.03.
Conclusions:
After the first two years of renal replacement therapy, transplantation demonstrates lower costs to the system when compared to other modalities evaluated. Based on that, this therapy justifies improvements in government policies in this sector.
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