Introduction and aims: Approximately 45,892 patients received renal replacement therapy (RRT) for end-stage renal disease (ESRD) as per the Italian Renal Registry Report 2010 report, resulting in a substantial economic burden. Published evidence suggests that peritoneal dialysis (PD) is as effective as in-center hemodialysis (ICHD) clinically. This study investigates the five-year healthcare budget impact of variable distribution of adult patients treated with PD and ICHD in Italy.
Methods: A Markov model was constructed reflecting the natural history of dialysis patients; based on this, a budget impact analysis was performed from the Italy payer perspective. We modelled a prevalent dialysis patient population over a 5-year time horizon. The current assumed Italy dialysis modality distribution (baseline: scenario 0) of 9% PD, 90% conventional ICHD, and 1% conventional home HD was compared to 3 hypothetical scenarios: Scenario 1: 30% PD; Scenario 2: 20% PD; Scenario 3: 5% PD. In all scenarios, the percentage of ICHD changed accordingly to 69%, 79%, and 94% respectively. Conventional home HD (1%) was assumed to be constant across all scenarios. Model parameters and data inputs were obtained from published articles, regional registries of Lombardy, Emila Romagna and Sicily regions in Italy, and the ERA-EDTA registry.
Results: Under the current best available cost information, an increase in the prevalent PD population from 9% to 20%, and 30%, is predicted to result in five-year cumulative savings of €129 million, and €259 million, respectively. If the prevalent PD population were to decrease from 9% to 5%, the total expenditure for dialysis treatments would increase by €65 million over the next five years.
Conclusions: This analysis shows that increasing the uptake of peritoneal dialysis regimen could reduce the financial burden associated with the increasing demand for dialysis services in Italy, without compromising patient outcomes.
A budget impact analysis of increasing peritoneal dialysis (PD) in Italy
This study investigates the five-year healthcare budget impact of variable distribution of adult patients treated with PD and ICHD in Italy.
Under the current dialysis tariff, increasing the proportion of patients requiring dialysis on PD could help the Italian payer reduce dialysis associated costs, without compromising patient outcomes.
Per inserire una domanda, segnalare la tua esperienza, un tuo commento o una richiesta di precisazione fai il login con il tuo nome utente e password.
Se non lo sei ancora puoi registrati partendo da qui.