J Korean Soc Transplant.  2015 Dec;29(4):200-208. 10.4285/jkstn.2015.29.4.200.

Quality of Life among End-stage Renal Disease Treatments and Economic Evaluation of Renal Transplantation and Hemodialysis Treatments

Affiliations
  • 1Organ Transplant Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 2Transplant Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Healthcare Management, Soonchunhyang University College of Medical Science, Asan, Korea.
  • 4Department of Surgery and the Research Institute for Transplantation, Yonsei University College of Medicine, Seoul, Korea. soonkim@yuhs.ac hmi@sch.ac.kr

Abstract

BACKGROUND
Although renal transplantation is known as the best treatment for patients with end-stage renal disease, there are few of literature to identify economic evaluation of renal replacement therapies in Korea. This study was conducted to determine the cost-effectiveness of renal replacement treatments, particularly renal transplantation and hemodialysis.
METHODS
We used the quality adjusted life year (QALY) calculated from survey data, which was collected from 124 patients who underwent kidney transplantation and 90 patients who were receiving hemodialysis. Medical costs were collected from five hospitals in Korea. The ERA-EDTA registry data (European Renal Association-European Dialysis and Transplant Association) were used for transition probability. A Markov model was used for predicting the cost-utility of transplantation and hemodialysis over the 10-year period.
RESULTS
Renal transplantation offers lower cost and better outcome compared to hemodialysis. QALY per year of transplantation patients is higher than that of hemodialysis patients (transplantation 0.9465 vs. hemodialysis 0.8297). Cost per QALY gained is 15,566,000 won in transplantation patients whereas 32,765,000 won per QALY gained in hemodialysis patients was required.
CONCLUSIONS
Although cost of first year after transplantation was expensive, over 2 years, transplantation was more effective and less costly than hemodialysis. The results suggest that transplantation is more cost-effective than hemodialysis in Korea.

Keyword

Cost-benefit analysis; Kidney transplantation; Hemodialysis; Chronic kidney failure

MeSH Terms

Cost-Benefit Analysis
Dialysis
Humans
Kidney Failure, Chronic*
Kidney Transplantation*
Korea
Quality of Life*
Quality-Adjusted Life Years
Renal Dialysis*
Renal Replacement Therapy

Reference

References

1). Ministry of Health and Welfare, Korea Center for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health Nutrition Examination Survey (KNHANES VI-1). Seoul, KR: Ministry of Health and Welfare;2014.
2). ESRD Registry Committee. Current renal replacement therapy in Korea: Insan memorial dialysis registry 2014. Seoul, KR: The Korean Society of Nephrology;2015.
3). Yang CW. Current status and future in patients with end stage renal disease in Korea. J Korean Med Assoc. 2013; 56:560–1. (양철우. 우리나라 말기신부전 환자의 현재와 미래. 대한의사협회지 2013;56: 560–1.).
Article
4). White S, Chadban S. Diabetic kidney disease in Australia: current burden and future projections. Nephrology (Carlton). 2014; 19:450–8.
Article
5). Jin DC. Current status of dialysis therapy for ESRD patients in Korea. J Korean Med Assoc. 2013; 56:562–8. (진동찬. 우리나라 말기신부전 환자의 투석현황. 대한의사협회지 2013;56: 562–8.).
Article
6). Stel VS, Kramer A, Zoccali C, Jager KJ. The 2007 ERA-EDTA registry annual report: a Precis. NDT Plus. 2009; 2:514–21.
7). Cleemput I, Kesteloot K, Vanrenterghem Y, De Geest S. The economic implications of non-adherence after renal transplantation. Pharmacoeconomics. 2004; 22:1217–34.
Article
8). Howard K, Salkeld G, White S, McDonald S, Chadban S, Craig JC, et al. The cost-effectiveness of increasing kidney transplantation and home-based dialysis. Nephrology (Carlton). 2009; 14:123–32.
Article
9). Kim CD. Kidney transplantation. Korean J Med. 2014; 86:142–51. (김찬덕. 신장이식. 대한내과학회지 2014;86: 142–51.).
Article
10). Perovic S, Jankovic S. Renal transplantation vs hemodialysis: cost-effectiveness analysis. Vojnosanit Pregl. 2009; 66:639–44.
Article
11). Lee YK, Nam HS, Chuang LH, Kim KY, Yang HK, Kwon IS, et al. South Korean time trade-off values for EQ-5D health states: modeling with observed values for 101 health states. Value Health. 2009; 12:1187–93.
Article
12). Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. 3rd ed.New York, NY: Oxford University Press;2005.
13). National Institute for Clinical Excellence. Guide to the methods of technology appraisal 2004. London, UK: National Institute for Clinical Excellence;2004.
14). Cavallo MC, Sepe V, Conte F, Abelli M, Ticozzelli E, Bottazzi A, et al. Cost-effectiveness of kidney transplantation from DCD in Italy. Transplant Proc. 2014; 46:3289–96.
Article
15). Kalo Z, Jaray J, Nagy J. Economic evaluation of kidney transplantation versus hemodialysis in patients with end stage renal disease in Hungary. Prog Transplant. 2001; 11:188–93.
16). Kim SI, Kim YS, Kim MS, Park EC, Jeon KO, Son SY, et al. A renal transplantation and hemodialysis cost-utility analysis in patients with end-stage renal disease. J Korean Soc Transplant. 2010; 24:173–81. (김순일, 김유선, 김명수, 박은철, 전경옥, 손선영, 등. 우리나라 말기 신부전 환자의 신장이식과 신장혈액투석과의 비용-효용 분석. 대한이식학회지 2010;24: 173–81.).
Article
17). Kim J, Hahm MI, Park EC, Park JH, Park JH, Kim SE, et al. Economic burden of cancer in South Korea for the year 2005. J Prev Med Public Health. 2009; 42:190–8. (김진희, 함명일, 박은철, 박재현, 박종혁, 김성은, 등. 2005년 암의 경제적 비용부담 추계. 예방의학회지 2009;42: 190–8.).
Article
18). Kim SG, Hahm MI, Choi KS, Seung NY, Shin HR, Park EC. The economic burden of cancer in Korea in 2002. Eur J Cancer Care (Engl). 2008; 17:136–44.
Article
19). Manns B, Meltzer D, Taub K, Donaldson C. Illustrating the impact of including future costs in economic evaluations: an application to end-stage renal disease care. Health Econ. 2003; 12:949–58.
Article
20). van Dijk PC, Jager KJ, de Charro F, Collart F, Cornet R, Dekker FW, et al. Renal replacement therapy in Europe: the results of a collaborative effort by the ERA-EDTA registry and six national or regional registries. Nephrol Dial Transplant. 2001; 16:1120–9.
Article
21). EuroQol Group. EQ-5D-3L user guide: basic information on how to use the EQ-5D–3L instrument. Rotterdam, NL: EuroQol Group;2013.
22). Park K, Park JH, Park JH, Kim HJ, Park BY. Does health status influence intention regarding screening mammog-raphy? Jpn J Clin Oncol. 2010; 40:227–33.
Article
23). Sanchez-Escuredo A, Alsina A, Diekmann F, Revuelta I, Esforzado N, Ricart MJ, et al. Economic analysis of the treatment of end-stage renal disease treatment: living-donor kidney transplantation versus hemodialysis. Transplant Proc. 2015; 47:30–3.
24). Yang F, Lau T, Lee E, Vathsala A, Chia KS, Luo N. Comparison of the preference-based EQ-5D–5L and SF-6D in patients with end-stage renal disease (ESRD). Eur J Health Econ. Epub 2014 Dec 18. DOI:. http://dx.doi.org/10.1007/s10198-014-0664-7.
25). Korea Centers for Disease Control and Prevention. Measuring health related quality of life using EQ-5D in South Korea: based on the results of KNHANES III and IV-1. Public Health Wkly Rep. 2009; 2(33):1–6. (울산대학교 의과대학 예방의학교실; 질병관리본부 질병예방센터 만성병조사과. EQ-5D로 살펴본 우리나라 성인의 건강 관련 삶의 질 수준: 국민건강영양조사 제3기 및 제4기 1차년도 결과를 중심으로. 주간 건강과질병 2009;2 33: 1–6.).
26). Korea Centers for Disease Control and Prevention. Korea Health Statistics 2013: Korea National Health and Nutrition Examination Survey (KNHANES VI-1). Sejong, KR: Ministry of Health and Welfare;2014.
27). Konig HH, Bernert S, Angermeyer MC, Matschinger H, Martinez M, Vilagut G, et al. Comparison of population health status in six european countries: results of a representative survey using the EQ-5D questionnaire. Med Care. 2009; 47:255–61.
28). Health Insurance Review and Assessment Service. Guidelines for economic evaluation of pharmaceuticals in Korea. Seoul, KR: HIRA;2006.
29). Stel VS, Kramar R, Leivestad T, Hoitsma AJ, Metcalfe W, Smits JM, et al. Time trend in access to the waiting list and renal transplantation: a comparison of four European countries. Nephrol Dial Transplant. 2012; 27:3621–31.
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