A Prospective Cost-Utility Study of Early Renal Replacement Therapy_Chinese Journal of Evidence-Based Medicine

Authors：

CHEN Min ¹ , LI Zi ¹ , HE Qiang ² , SU Baihai ¹ , LUO H ai ¹ , MA Xingyi ¹ , XUE Hen ¹ , KANG Deying ³ , JIAN Xun ⁴ , FAN Junming ¹

1. Department of Nephrology, West China Hospital, Sichuan University, Chengdu 610041, China2. Department of Nephrology, People’s Hospital of Sichuan, Chengdu 610072, China3. Chinese Cochrane Centre, West China Hospital, Sichuan University, Chengdu 610041, China4. Department of Nephrology, 404 Hospital of Mianyang, Mianyang 621000, China;

Corresponding author：

Keywords：

End-stage renal disease; Hemodialysis; Ambulatory peritoneal dialysis; Renal tran splantation; Cost-utility

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Objective 　To assess the cost-utility study of renal transplantation compared with nemodialysis (HD) and peritoneal dialysis (PD).
Methods 　A prospective study of end-stage renal disease patients was followed up for 3 months after renal replacement therapy. The study population included 196 patients (renal transplant [RT] n=63, hemodialysis [HD] n=82 and continious ambulatory peritoneal dialysis [CAPD] n=51) from 6 hospitals of Sichuan province. Health-related quality of life was assessed by using the WHOQOL-BRIEF questionnaire. Utility scores were obtained so as to conduct CUA (cost-utility analysis). Costs were collected from financial department and by patient interview.
Results 　The utility values were 0.539 9± 0.013 for RT, 0.450 8± 0.014 for HD, 0.512 2±0.099 for CAPD, respectively. The mean direct cost of the first three months of renal transplant was significantly higher than dialysis (RT and CAPD). Over 3 months, the average cost per quality-adjusted life year (QALY) for patients after CAPD was lower than HD and RT. Compared to HD, incremental cost analysis showed that CAPD was more ecnomical than RT. Sensitive analysis showed that CAPD was more effective than RT when ΔQALY varied in the limit of 95% confidence interval. However, the cost-utility of RT vs HD and CAPD vs HD was varied with ΔQALY level.
Conclusions 　Cost-utility analysis showed that CAPD was a more favorable cost-utility ratio when compared to RT at early stage RT vs HD and CAPD vs HD, but which cost-utility ratio is better, we can not draw a certain conclusion.

Citation： CHEN Min,LI Zi,HE Qiang,SU Baihai,LUO H ai,MA Xingyi,XUE Hen,KANG Deying,JIAN Xun,FAN Junming. A Prospective Cost-Utility Study of Early Renal Replacement Therapy. Chinese Journal of Evidence-Based Medicine, 2004, 04(7): 453-459. doi: Copy

1.	［1］Ikeles C.Kidney failure and transplantation in China [J].Soc-sci Med,1997; 44(9):1 271-1 283.
2.	［2］Chen HZ,Editor-in-chief.Utility Internal Medicine [M].10th.ed.Beijing:People’s Medical Publishing House,1997; p.1 755.
3.	陈灏珠,主编.实用内科学 [M].第十版.北京:人民卫生出版社,1997.p1 755.
4.	［3］Wang JL,Editor-in-chief.Clinical Epidemiology-ClinicalResearch Design,Measurement and Evaluation [M].2nd ed.Shanghai:Shanghai Science Technology Publication House,2001; p.373-375.
5.	王家良,主编.临床流行病学--临床科研设计、衡量与评价 [M].第2版.上海:上海科学技术出版社,2001.p373～375.
6.	［4］Wang JL,Editor-in-chief.Evidence-Based Medicine [M].1st ed.Beijing:People’s Medical Publishing House,2001; p.102-104.
7.	王家良,主编.循证医学 [M].第1版.北京:人民卫生出版社,2001.p102～104.
8.	［5］Wang XW,Liu BP.Health Care Economics [M].1st ed.Changsha:National defense technology publication house,1999; p.131-140.
9.	王小万,刘保平.卫生保健经济学 [M].第1版.长沙:国防科技大学出版社,1999.p131-140.
10.	［6］He HM,Zhou CM.Health Economics [M].1st ed.Shanghai:Shanghai Science Popularit Publishing House,1987; p.227-228.
11.	何鸿明,周采铭.卫生经济学 [M].第1版.上海:上海科学普及出版社,1987.p227～228.
12.	［7］Yang ZW,Zhang J.The method and application of Cost-Utility Analysis [J].China Pharmacy,1998; 9(2):54-55.
13.	杨樟卫,张钧.成本效用分析方法与应用 [J].中国药房,1998; 9(2):54～55.
14.	［8］Rodriguez-Carmona A,Perez Fontan M,Bonza P,Garcia Falcon T,Valdes F.The economic cost of dialysis:a comparison between Peritoneal dialysis and in-center hemodialysis in a Spanish Unit [J].Adv Perit Dial,1996; 12:93-96.
15.	［9］Kaminota M.cost-effectiveness analysis of dialysis and kidney transplants in Japan [J].Keio J Med,2001; 50(2):100-108.

1. ［1］Ikeles C.Kidney failure and transplantation in China [J].Soc-sci Med,1997; 44(9):1 271-1 283.
2. ［2］Chen HZ,Editor-in-chief.Utility Internal Medicine [M].10th.ed.Beijing:People’s Medical Publishing House,1997; p.1 755.
3. 陈灏珠,主编.实用内科学 [M].第十版.北京:人民卫生出版社,1997.p1 755.
4. ［3］Wang JL,Editor-in-chief.Clinical Epidemiology-ClinicalResearch Design,Measurement and Evaluation [M].2nd ed.Shanghai:Shanghai Science Technology Publication House,2001; p.373-375.
5. 王家良,主编.临床流行病学--临床科研设计、衡量与评价 [M].第2版.上海:上海科学技术出版社,2001.p373～375.
6. ［4］Wang JL,Editor-in-chief.Evidence-Based Medicine [M].1st ed.Beijing:People’s Medical Publishing House,2001; p.102-104.
7. 王家良,主编.循证医学 [M].第1版.北京:人民卫生出版社,2001.p102～104.
8. ［5］Wang XW,Liu BP.Health Care Economics [M].1st ed.Changsha:National defense technology publication house,1999; p.131-140.
9. 王小万,刘保平.卫生保健经济学 [M].第1版.长沙:国防科技大学出版社,1999.p131-140.
10. ［6］He HM,Zhou CM.Health Economics [M].1st ed.Shanghai:Shanghai Science Popularit Publishing House,1987; p.227-228.
11. 何鸿明,周采铭.卫生经济学 [M].第1版.上海:上海科学普及出版社,1987.p227～228.
12. ［7］Yang ZW,Zhang J.The method and application of Cost-Utility Analysis [J].China Pharmacy,1998; 9(2):54-55.
13. 杨樟卫,张钧.成本效用分析方法与应用 [J].中国药房,1998; 9(2):54～55.
14. ［8］Rodriguez-Carmona A,Perez Fontan M,Bonza P,Garcia Falcon T,Valdes F.The economic cost of dialysis:a comparison between Peritoneal dialysis and in-center hemodialysis in a Spanish Unit [J].Adv Perit Dial,1996; 12:93-96.
15. ［9］Kaminota M.cost-effectiveness analysis of dialysis and kidney transplants in Japan [J].Keio J Med,2001; 50(2):100-108.

Chinese Journal of Evidence-Based Medicine

A Prospective Cost-Utility Study of Early Renal Replacement Therapy

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