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Table 2 Cost elements considered in the model

From: The financial impact of increasing home-based high dose haemodialysis and peritoneal dialysis

Parameter

Value (range)

Data sources

Access costs

 

Vascular access cost

£1,287 (£965 - £1,609)

PbR tariff 2013-2014 [41]

Peritoneal access costs (PD specific)

£1,233 (£854 – £1,423)

PbR tariff 2013-2014 [41]

Dialysis service costs

ICHD cost per session

  

  Catheter access

£121 (£92 - £154)

PbR tariff 2013-2014 [41]

  AV fistula/graft access

£152 (£115 - £191)

  Weighted

£147

Breakdown based on the target percentage set by the best practice tariff for 2013/14 [50]

Home HD cost per week

£456 (£342 - £570)

PbR tariff 2013-2014 [41]

PD cost per day

  

  APD

£52 (£39 - £65)

PbR tariff 2013-2014 [41]

  CAPD

£46 (£35 - £58)

 

ESA costs

ESA cost per 1,000 units Dose (units/week)

£5.09 (£3.82 - £6.36)

BNF No. 64 [43]

  HD (all sub-modalities)

6,705 (5,029 – 8,381)

Rao [51]

  PD (all sub-modalities)

3,700 (2,775 – 4,625)

Rao [51]

Monitoring costs †

  Single professional

£132 (£99 - £165)

PbR tariff 2013-2014 [41]

  Multi professional

£247 (£185 - £309)

 

  Weighted

£190

Equal weighting assumed.

Hospitalisation costs

HD hospitalisation

£1,904 (£1,482 - £2,380)

Event costs from the PbR tariff 2013-2014 [41]. Event numbers from the National Schedule of Reference Costs 2011-12 [42]

PD hospitalisation

£1,596 (£1,197 - £1,995)

Transport cost per visit

ICHD sessions ‡

£46

Breakdown based on the National Kidney Care Audit, Patient Transport Survey 2010 [45]

Transplant costs §

Transplant procedure cost

£18,579

National Schedule of Reference Costs 2012-13 [48] Breakdown based on the NHS Blood and Transplant Activity Report for 2012-13 [32]

Post-transplant medication costs

£11,137 (£8,352 - £13,921)

NHS Kidney Care report [47]

  1. Abbreviations: APD Automated peritoneal dialysis, CAPD Continuous ambulatory peritoneal dialysis, CC Complications or comorbidity, ESA Erythropoiesis stimulating agents, HD Haemodialysis, ICHD In-centre haemodialysis, PD Peritoneal dialysis.
  2. †Patients on each modality are assumed to receive two monitoring visits/year.
  3. ‡Breakdown of transport costs are as follows: ambulance service vehicle - £189 (£142 - £236) [46]; Hospital-provided car £27 (£20 - £34) [45]; Hospital-arranged taxi £31 (£23 - £39) [45]; Hospital transport vehicle £13 (£10 - £16) [52]; public £5 (£4 - £6), based on assumption; private £5 (£4 - £6), based on assumption. §Breakdown of transport costs are as follows: donor after brain death £19,804 (£14,853 - £24,755) [48]; donor after cardiac death £16,580 (£12,435 - £20,725) [48]; living donor £18,640 (£13,980 - £23,300) [49].
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BMC Nephrology

ISSN: 1471-2369

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