Lifetime cost-effectiveness analysis of first-line dialysis modalities for patients with end-stage renal disease under peritoneal dialysis first policy

Table 1 Unit cost of each healthcare service related to patients with end-stage renal disease

Healthcare service	Cost (USD)	Reference
General outpatient clinic (per visit)	57.1	Hospital Authority [14]
Specialist outpatient clinic (per visit)	152.6	Hospital Authority [14]
Accident and emergency (per visit)	157.7	Hospital Authority [14]
Hospital stay (per night)	653.8	Hospital Authority [14]
Haemodialysis (per session)	384.6	Hospital Authority [14]
PD home machine rental consumables, maintenance and insurance (per month)	641.0	Personal communication with nephrologists
Home-based HD machine rental and consumables (per month)	769.2	Personal communication with nephrologists
Pre-dialysis access surgery
PD: insertion / removal of peritoneal dialysis catheter	3192.3	Hospital Authority [15]
HD: Insertion / removal of haemodialysis catheter ^b	2057.7	Hospital Authority [15]
HD: Arteriovenostomy for renal dialysis (arteriovenous fistula, arteriovenous graft) ^b	6384.6	Hospital Authority [15]. Personal communication with nephrologists
Renal transplantation	10,278.8	Hospital Authority [15]
Post-transplant follow-up^c		Personal communication with nephrologists
Initial year	1678.2
Subsequent years	610.3
Dialysis training^a		Personal communication with nephrologists
PD^d	1692.3
Hospital-based HD	0
Home-based HD	12,184.6
Re-training after peritonitis^a,d		Personal communication with nephrologists
PD	1692.3

^aDialysis training cost for PD = USD42.3 × 8 h × 5 days × 1 week = USD1392.3; Hospital-based HD = 0; Dialysis training cost for Home-based HD = USD42.3 × 8 h × 3 days × 12 weeks = USD12184.6.
(Median hourly wage of Registered Nurse in 2017 = USD42.3)
^bThe ratio for HD: Insertion / removal of haemodialysis catheter vs. Arteriovenostomy for renal dialysis (arteriovenous fistula, arteriovenous graft) = 3:7, with reference to recommendation by nephrologists
^c Post-transplant patients in initial year were assumed to attend eleven times at specialist outpatient clinics (USD152.6 × 11 times = USD1678.2). Post-transplant patients in second years were assumed to attend four times at specialist outpatient clinics (USD152.6 × 4 times = USD610.3)
^dPD patients are required for re-training after every 5 years for PD life extension

ISSN: 1471-2369