Publication
A Prospective Assessment of Renal Transplantation Versus Haemodialysis: Which Therapeutic Modality Is Good Value for Society?
| dc.contributor.author | Domingos, M | |
| dc.contributor.author | Gouveia, M | |
| dc.contributor.author | Pereira, J | |
| dc.contributor.author | Nolasco, F | |
| dc.date.accessioned | 2015-01-23T15:35:03Z | |
| dc.date.available | 2015-01-23T15:35:03Z | |
| dc.date.issued | 2014 | |
| dc.description.abstract | Background: Economic evaluations help health authorities facing budget constraints. This study compares the health-related quality of life (HRQOL) and costs in patient subgroups on haemodialysis (HD) and renal transplantation (KT). Methods: In a prospective study with follow-up of 1-3 years, we performed a costutility analysis of KT vs. HD, adopting a lifetime horizon. A societal perspective was taken. Costs for organ procurement, KT eligibility, transplant surgery and follow-up of living donors were included. Key clinical events were recorded. HRQOL was assessed using the EuroQol instrument. Results: The HRQOL remained stable on HD patients. After KT, mean utility score improved at 3 months while mean EQ-VAS scores showed a sustained improvement. Mean annual cost for HD was 32,567.57€. Mean annual costs for KT in the year-1 and in subsequent years were, 60,210.09€ and 12,956.77€ respectively. Cost for initial hospitalization averaged 18,740.74€. HLA-mismatches increased costs by 75% for initial hospitalization (p < 0.001) and 41% in the year-1 (p < 0.05), and duplicate the risk of readmission in the year-1 (p < 0.05). The incremental costutility ratio was 5,534.46€/QALY, increasing 35% when costs for organ procurement were added. KT costs were 41,541.63€ more but provided additional 7.51 QALY. Conclusions: The KT is cost-effective compared with HD. Public funding should reflect the value created by the intervention and adapt to the organ demand. | por |
| dc.identifier.citation | Port J Nephrol Hypert 2014; 28 (4): 300-308 | por |
| dc.identifier.uri | http://hdl.handle.net/10400.17/1993 | |
| dc.language.iso | eng | por |
| dc.peerreviewed | yes | por |
| dc.publisher | Sociedade Portuguesa de Nefrologia | por |
| dc.subject | HCC NEF | por |
| dc.subject | Economics | por |
| dc.subject | Renal Dialysis | por |
| dc.subject | Prospective Studies | por |
| dc.subject | Cost Efficiency Analysis | por |
| dc.subject | QALY | por |
| dc.subject | Quality-Adjusted Life Years | por |
| dc.subject | Kidney Transplantation | por |
| dc.title | A Prospective Assessment of Renal Transplantation Versus Haemodialysis: Which Therapeutic Modality Is Good Value for Society? | por |
| dc.title.alternative | Uma Avaliação Prospectiva do Transplante Renal Versus Hemodiálise: na Perspectiva Social, Qual a Melhor Modalidade Terapêutica? | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 308 | por |
| oaire.citation.startPage | 300 | por |
| oaire.citation.title | Portuguese Journal of Nephrology & Hypertension | por |
| rcaap.rights | openAccess | por |
| rcaap.type | article | por |