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Cost‐Effectiveness of Maintenance Hemodialysis in J apan
Author(s) -
Takura Tomoyuki,
Nakanishi Takeshi,
Kawanishi Hideki,
Nitta Kosaku,
Akizawa Tadao,
Hiramatsu Makoto,
Kawasaki Tadayuki,
Kukita Kazutaka,
Soejima Hidehisa,
Hirakata Hideki,
Yoshida Toyohiko,
Miyamoto Takashi,
Takahashi Susumu
Publication year - 2015
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12314
Subject(s) - medicine , hemodialysis , dialysis , diabetic nephropathy , nephropathy , kidney disease , quality of life (healthcare) , kidney , diabetes mellitus , endocrinology , nursing
The cost‐effectiveness according to primary disease or dialysis duration has never been analyzed with respect to maintenance hemodialysis ( MHD ). Study candidates were > 20 years of age and had received hemodialysis for at least 6 months. Hemodialysis patients were prospectively observed for 36 months, and patient utility was assessed based on the E uro‐ QOL 5‐dimensions ( EQ ‐5 D ), from which the quality adjusted life years ( QALYs ) were estimated. Medical costs were calculated based on medical service fees. The cost‐effectiveness defined as the incremental cost utility ratio ( ICUR ) was analyzed from a social perspective. A total of 29 patients (mean age; 59.9 ± 13.1 years) undergoing 437 dialysis sessions were analyzed. Utility based upon the EQ ‐5 D score was 0.75 ± 0.21, and the estimated total medical cost for one year of MHD treatment was 4.52 ± 0.88 US $10 000. ICUR was 6.88 ± 4.47 US $10 000/ QALY on average, and when comparing ICUR based on the causes of kidney failure, the value for diabetic nephropathy was found to be higher than that for glomerulonephritis (8.17 ± 6.28 vs. 6.82 ± 4.07). ICUR after 36 months observation increased mainly in the patients below 65 years of age (All; P < 0.05, <65; P < 0.01, 65≤; not significant). MHD is a treatment that could improve the socioeconomic state of elderly patients with end‐stage kidney disease ( ESKD ), but the ICUR for diabetic nephropathy was higher than that for glomerulonephritis.