Cost-effectiveness of interventions for end-stage renal disease

Objective The study reports the cost-effectiveness results of end-stage ren al disease (ESDR) patients in Mexico in terms of years of life gained and q uality of life and the economic cost with regards to three treatment altern atives that could be considered mutually exclusive: continuous peritoneal a mbulatory dialysis (CAPD), hemodialysis (HD) and renal transplant (RT). Method The economic costs were calculated by using the average cost case-ma nagement methodology and further; the probable of life expectancy and the q uality of life were cross-sectionally assessed by means of the Quality Adju sted Life Years (QALY) measured by the Rosser Index. Results The results show that economic costs in US$ of the three treatment alternatives were: CAPD $5,643.07 HD $9,631.60, and RT $3,021.63. The proba bility of life expectancy for CAPD and RT for the first and third year were : 86.2% and 66.9%, and 89.9% and 79.6%, respectively The QALY scares Soi pa tients were: CAPD 0.8794, HD 0.8640 and RT 0.9783. Conclusion The intervention with the highest cost-effectiveness coefficient was the renal transplant (3,088.69), followed by the CAPD (6,416.95) and H D (11,147.68). A significant difference was found between the transplanted patients and patients undergoing dialysis. Finally, this study concluded th at the RT offers the least expensive alternative and the greatest number of years of life gained as well as providing significant changes in the quali ty of life of ESRD patients.