TY - JOUR
T1 - The cost-utility of haemodiafiltration versus haemodialysis in the Convective Transport Study
AU - Mazairac, Albert H. A.
AU - Blankestijn, Peter J.
AU - Grooteman, Muriel P. C.
AU - Penne, E. Lars
AU - van der Weerd, Neelke C.
AU - den Hoedt, Claire H.
AU - Buskens, Erik
AU - van den Dorpel, Marinus A.
AU - ter Wee, Piet M.
AU - Nubé, Menso J.
AU - Bots, Michiel L.
AU - de Wit, G. Ardine
AU - AUTHOR GROUP
AU - Dorval, M.
AU - Lévesque, R.
AU - Koopman, M. G.
AU - Konings, C. J. A. M.
AU - Haanstra, W. P.
AU - Kooistra, M.
AU - Noordzij, T.
AU - Feith, G. W.
AU - van Buren, M.
AU - Offerman, J. J. G.
AU - Hoogeveen, E. K.
AU - de Heer, F.
AU - van de Ven, P. J.
AU - Kremer Hovinga, T. K.
AU - Bax, W. A.
AU - Groeneveld, J. O.
AU - Lavrijssen, A. T. J.
AU - Schrander-van der Meer, A. M.
AU - Reichert, L. J. M.
AU - Huussen, J.
AU - Rensma, P. I.
AU - Schrama, Y.
AU - van Hamersvelt, H. W.
AU - Boer, W. H.
AU - van Kuijk, W. H.
AU - Vervloet, M. G.
AU - Wauters, I. M. P. M. J.
AU - Sekse, I.
PY - 2013
Y1 - 2013
N2 - Despite the growing interest in haemodiafiltration (HDF), there is no information on the costs and cost-utility of this dialysis modality yet. It was therefore our objective to study the cost-utility of HDF versus haemodialysis (HD). A cost-utility analysis was performed using a Markov model. It included data from the Convective Transport Study (CONTRAST), a randomized controlled trial that compared online HDF with low-flux HD. Costs were estimated using a societal perspective. Probabilistic sensitivity analyses were performed to study uncertainty. Total annual costs for HDF and HD were €88 622±19,272 and €86,086±15,945, respectively (in 2009 euros). When modelled over a 5-year period, the incremental cost per quality-adjusted life year (QALY) of HDF versus HD was €287,679. Sensitivity analyses revealed that this amount will not fall below €140,000, even under the most favourable assumptions like a high-convection volume (>20.3 L). Based on accepted societal willingness-to-pay thresholds, HDF cannot be considered a cost-effective treatment for patients with end-stage renal disease at present. Apparently, minor additional costs of HDF are not counterbalanced by a relevant QALY gain
AB - Despite the growing interest in haemodiafiltration (HDF), there is no information on the costs and cost-utility of this dialysis modality yet. It was therefore our objective to study the cost-utility of HDF versus haemodialysis (HD). A cost-utility analysis was performed using a Markov model. It included data from the Convective Transport Study (CONTRAST), a randomized controlled trial that compared online HDF with low-flux HD. Costs were estimated using a societal perspective. Probabilistic sensitivity analyses were performed to study uncertainty. Total annual costs for HDF and HD were €88 622±19,272 and €86,086±15,945, respectively (in 2009 euros). When modelled over a 5-year period, the incremental cost per quality-adjusted life year (QALY) of HDF versus HD was €287,679. Sensitivity analyses revealed that this amount will not fall below €140,000, even under the most favourable assumptions like a high-convection volume (>20.3 L). Based on accepted societal willingness-to-pay thresholds, HDF cannot be considered a cost-effective treatment for patients with end-stage renal disease at present. Apparently, minor additional costs of HDF are not counterbalanced by a relevant QALY gain
U2 - https://doi.org/10.1093/ndt/gft045
DO - https://doi.org/10.1093/ndt/gft045
M3 - Article
C2 - 23766337
SN - 0931-0509
VL - 28
SP - 1865
EP - 1873
JO - Nephrology, dialysis, transplantation
JF - Nephrology, dialysis, transplantation
IS - 7
ER -