Introduction: Living donor kidney transplantation (LDKT) is the optimal treatment for most patients with end-stage renal disease (ESRD). Unfortunately, a significant number of these patients cannot find a living donor kidney. Previous research showed that a home-based intervention increases knowledge on renal replacement therapies (RRT), increases the communication skills to discuss this knowledge with the social network of the patients, and increases LDKT. These studies resulted in an implementation project started in 2016. To support continued implementation of this intervention a cost-effectiveness assessment is warranted. In this study, the cost-effectiveness of the intervention and the RRT program in The Netherlands were evaluated. Methods: The cost-effectiveness is assessed with a probabilistic dynamic Markov model, using Monte Carlo simulations. The base-case scenario of the Dutch RRT program was compared with a scenario in which the intervention is implemented. Health states used in the model were peritoneal dialysis (CAPD, APD), hemodialysis (Center Hemodialysis and Home hemodialysis), deceased donor kidney transplantation and living donor kidney transplantation. Costs and quality adjusted life years (QALYs) were derived from the literature. Intervention costs were calculated with data obtained from the ongoing implementation project and was estimated to be €2811. Incidence rates and prevalence were obtained from a national database of patients with end-stage renal disease. A time horizon of 10 years was used. Outcomes of the analyses were presented as an incremental cost-effectiveness ratio (ICER). Several scenario analyses were conducted, in which the intervention effects and costs were varied. Results: The data suggests that the home-based intervention offers both better effects and lower costs for ESRD patients compared to standard care from the second year onwards, (an ICER of -€27.163 in year 2), indicating that for every QALY gained, €27.163 is saved for society. After ten years, the ICER is estimated to be -€29.906. Results show that there is little uncertainty surrounding the ICERs. In the worst-case scenario, in terms of intervention effects and costs, the intervention is cost-saving and offers more QALYs from the third year onwards. Discussion: Results of this study indicate that the home-based intervention offers an improvement in care for patients compared to standard care, while it saves costs for society. In the Dutch context the cost-savings lead up to millions of euros per year. Since there is little uncertainty around the outcome, we recommend uptake of the Kidney Team at Home in standard-care and structural financing for this effective intervention.