Cost-effectiveness Analysis of Renal Replacement Therapy in Austria.

M. Haller(1,2), G. Gutjahr(3), R. Kramar(4), F. Harnoncourt(1), R. Oberbauer(1,2,4)

1- Department of Nephrology, KH Elisabethinen, Linz, Austria

2- Department of Nephrology, Medical University Vienna, Austria

3- Core Unit of Medical Statistics and Informatics, Medical University Vienna, Austria

4- Austrian Dialysis and Transplant Registry, Austria

 

Webtables 1-3:

Results of the cost center accounting at the Hospital Elisabethinen Linz (EHL) in 2008 are shown for each renal replacement treatment modality unit separately to make staff costs, material costs, overhead costs comparable between hemodialysis, peritoneal dialysis and kidney transplantation. Subtotals for staff costs, medical consumable goods, administration or energy supply for example are fat marked, sum of primary and secondary costs are underlined with dots, total costs are underlined and total costs less services for other departments in the hospital are underlined double. For some cost variables we could only publish subtotals but no detailed costs due to privacy policies of the EHL.

 

// Tables
// Figures

Webtable 1:
Webtable 1:

Cost variables for peritoneal dialysis patients. Cost center accounting for Peritoneal Dialysis Unit in 2008.

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Webfigure 1:
Webfigure 1:

Probabilistic sensitivity analysis for the policy of increasing PD assignment to 20% and TL to 10%. The model is replicated a large number of times (105 replications) whereby in each of these replications every parameter value is drawn from a distribution (see Table 2 and 3). Webfigure 1a shows the resulting distribution of discounted cost savings and Webfigure 1b the resulting distribution of discounted effect gains for the policy of increasing PD assignment to 20% and TL to 10% compared to the baseline policy (annual discount rate 3%). The horizontal bars denote the range from the 2.5% percentile to the 97.5% percentile: 7.1 to 71.4 Million Euros as the range of cost savings and 62 to 4096 QALYs as range for the effect gain. The dots at the bottom of the figures indicate medians: 40.1 Million Euros as the median for cost savings and 2076 QALYs as the median of effect gains.

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Webtable 2:
Webtable 2:

Cost variables for hemodialysis patients. Cost center accounting for Hemodialysis Unit in 2008.

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Webtable 3:
Webtable 3:

Cost variables for kidney transplant patients. Cost center accounting for Kidney Transplant Unit in 2008.

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Webtable 4:
Webtable 4:

Estimated therapy costs (in EUR 100/month) with standard deviations. Data from the EHL and the Upper Austrian Health Insurance were used for the cost parameters. Total annual therapy costs include costs for inpatient and outpatient treatment, including non-ESRD related admissions, costs for medications including ESAs and i.v. iron, costs for transportation to the renal unit as well as costs for renal replacement therapy itself. Costs were distinguished between the first year (0-12 months), the second year (13-24 months) and subsequent years (beyond 25 months) after initiation of the treatment for hemodialysis, peritoneal dialysis and kidney transplantation. Annual therapy costs for kidney transplantation during the first 12 months were furthermore separated depending on the donor source (living donor or deceased donor). Note that the column SD refers to the sample standard deviation and not to the standard deviation of the mean (i.e., the standard error).

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SCIENTIFIC COLLABORATIONS