Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/1993
Título: A Prospective Assessment of Renal Transplantation Versus Haemodialysis: Which Therapeutic Modality Is Good Value for Society?
Outros títulos: Uma Avaliação Prospectiva do Transplante Renal Versus Hemodiálise: na Perspectiva Social, Qual a Melhor Modalidade Terapêutica?
Autor: Domingos, M
Gouveia, M
Pereira, J
Nolasco, F
Palavras-chave: HCC NEF
Economics
Renal Dialysis
Prospective Studies
Cost Efficiency Analysis
QALY
Quality-Adjusted Life Years
Kidney Transplantation
Data: 2014
Editora: Sociedade Portuguesa de Nefrologia
Citação: Port J Nephrol Hypert 2014; 28 (4): 300-308
Resumo: 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.
Peer review: yes
URI: http://hdl.handle.net/10400.17/1993
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