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Zahirian Moghadam, Telma; Powell, Jane; Sharghi, Afshan; Zandian, Hamed

Economic evaluation of dialysis and comprehensive conservative care for chronic kidney disease using the ICECAP-O and EQ-5D-5L; a comparison of evaluation instruments

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  • Medientyp: E-Artikel
  • Titel: Economic evaluation of dialysis and comprehensive conservative care for chronic kidney disease using the ICECAP-O and EQ-5D-5L; a comparison of evaluation instruments
  • Beteiligte: Zahirian Moghadam, Telma; Powell, Jane; Sharghi, Afshan; Zandian, Hamed
  • Erschienen: Springer Science and Business Media LLC, 2023
  • Erschienen in: Cost Effectiveness and Resource Allocation
  • Sprache: Englisch
  • DOI: 10.1186/s12962-023-00491-3
  • ISSN: 1478-7547
  • Schlagwörter: Health Policy
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Chronic Kidney Disease (CKD) patients often require long-term care, and while Hemodialysis (HD) is the standard treatment, Comprehensive Conservative Care (CCC) is gaining popularity as an alternative. Economic evaluations comparing their cost-effectiveness are crucial. This study aims to perform a cost-utility analysis comparing HD and CCC using the EQ-5D-5L and ICECAP-O instruments to assessing healthcare interventions in CKD patients.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>This short-term economic evaluation involved 183 participants (105 HD, 76 CCC) and collected data on demographics, comorbidities, laboratory results, treatment costs, and HRQoL measured by ICECAP-O and EQ-5D-5L. Incremental Cost-Effectiveness Ratios (ICERs) and Net Monetary Benefit (NMB) were calculated separately for each instrument, and Probabilistic Sensitivity Analysis (PSA) assessed uncertainty.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>CCC demonstrated significantly lower costs (mean difference $8,544.52) compared to HD. Both EQ-5D-5L and ICECAP-O indicated higher Quality-Adjusted Life Years (QALYs) for both groups, but the difference was not statistically significant (p &gt; 0.05). CCC dominated HD in terms of HRQoL measures, with ICERs of -$141,742.67 (EQ-5D-5L) and -$4,272.26 (ICECAP-O). NMB was positive for CCC and negative for HD, highlighting its economic feasibility.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>CCC proves a preferable and more cost-effective treatment option than HD for CKD patients aged 65 and above, regardless of the quality-of-life measure used for QALY calculations. Both EQ-5D-5L and ICECAP-O showed similar results in cost-utility analysis.</jats:p> </jats:sec>
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