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

• Jeon KO
• Son SY
• Hahm MI
• Kim SI

• KMID: 2202605
• DOI: http://doi.org/10.4285/jkstn.2015.29.4.200

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