Abstract
End-Stage Renal Disease (ESRD) represents one of the most challenging social and medical problems mainly due to substantial treatment-associated costs. The chronic nature of the disease needs expensive continuous care that majority of the patients cannot afford. Therefore, in many countries expenses associated with the ESRD treatment is paid by state government. These treatment options include: hemodialysis, peritoneal dialysis and kidney transplantation. Multiple studies have been conducted throughout the world to assess cost-effectiveness of these treatment modalities. The studies suggest that kidney transplantation not only reduces mortality and morbidity but improves a quality of life of ESRD patients. Furthermore, it is the most cost-effective treatment for the ESRD at least in high-income countries. The goal of our study was to determine whether above-mentioned is true for lower middle income countries, where the cost of the ESRD treatment is substantially lower. Despite the low dialysis costs, transplantation remains the cheapest form of renal replacement therapy RRT in lower income countries like Georgia. Our results reveal, that kidney transplantation is most expensive modality of Renal Replacement Therapy (RRT) at month 1, but count of costs reveals that after the 10th month of treatment, the cumulative cost of transplantation is less than the cumulative cost of peritoneal dialysis and after the 23rd month, cumulative cost of hemodialysis also surpasses the cumulative cost of transplantation-related treatment and this cost comparison is in line with global data from upper-middle and high income countries.
Highlights
Worldwide, End-Stage Renal Disease (ESRD) represents one of the most challenging social and medical problems due to substantial treatment-associated costs
Serbia—A study conducted in Serbia aimed to compare ratio of costs and effects (Cost Effectiveness Analysis—CEA) of hemodialysis and kidney transplantation in patients with End-Stage Renal Disease
The eight studies above argue that kidney transplantation represents the most cost effective treatment option for End-Stage Renal Disease compared to hemodialysis and peritoneal dialysis
Summary
End-Stage Renal Disease (ESRD) represents one of the most challenging social and medical problems due to substantial treatment-associated costs. In many countries expenses associated with the ESRD treatment is paid by state government. Multiple studies have been conducted throughout the world to assess costeffectiveness of these treatment modalities. These studies suggest that kidney transplantation reduces mortality and morbidity but improves a quality of life of ESRD patients. It is the most cost-effective treatment for the ESRD at least in upper-middle and high income countries. The goal of our study was to determine whether above-mentioned is true for lower-middle income countries, where the overall costs of the ESRD treatment is substantially lower. We aim to suggest policy improvements that would promote costeffective methods of treatment, which will help relatively low-income Governments such as of Georgia to make available better possible treatment services to the greatest possible number of people with ESRD
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