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Cost-effectiveness analysis of hemodialysis plus hemoperfusion versus hemodialysis alone in adult patients with end-stage renal disease in China.
Wang, Haiyin; Jin, Huajie; Cheng, Wendi; Qin, Xiaoxiao; Luo, Yashuang; Liu, Xin; Fu, Yuyan; Jiang, Gengru; Lu, Wei; Jin, Chunlin; Pennington, Mark.
Afiliación
  • Wang H; Health Technology Assessment Research Department, Shanghai Health Development Research Centre, Shanghai, China.
  • Jin H; King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK.
  • Cheng W; Health Technology Assessment Research Department, Shanghai Health Development Research Centre, Shanghai, China.
  • Qin X; Health Technology Assessment Research Department, Shanghai Health Development Research Centre, Shanghai, China.
  • Luo Y; Health Technology Assessment Research Department, Shanghai Health Development Research Centre, Shanghai, China.
  • Liu X; Health Technology Assessment Research Department, Shanghai Health Development Research Centre, Shanghai, China.
  • Fu Y; Health Technology Assessment Research Department, Shanghai Health Development Research Centre, Shanghai, China.
  • Jiang G; Renal Division, Department of Internal Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Lu W; Renal Division, Department of Internal Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  • Jin C; Health Technology Assessment Research Department, Shanghai Health Development Research Centre, Shanghai, China.
  • Pennington M; King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, UK.
Ann Transl Med ; 9(14): 1133, 2021 Jul.
Article en En | MEDLINE | ID: mdl-34430574
BACKGROUND: This study evaluates the cost-effectiveness of hemodialysis (HD) plus hemoperfusion (HP) with HD alone in adult patients with end-stage renal disease (ESRD) in China. METHODS: A Markov model was constructed to assess the cost-effectiveness of interventions over a lifetime horizon. Model parameters were informed by the HD/HP trial, the first randomized, open-label multicenter trial comparing survival outcomes and incidence of cardiovascular disease (CVD) for HD + HP versus HD alone, and supplemented by published literature and expert opinion. The primary outcome was the incremental cost-effectiveness ratio (ICER) with respect to quality adjusted life-years (QALY). The robustness of the results was examined in extensive sensitivity analyses. Analyses were conducted from a healthcare perspective. Costs were reported in both Chinese Renminbi (RMB) and US Dollars (USD) in 2019 values. RESULTS: The base case ICER of HD + HP is RMB 174,486 (USD 25,251) per QALY, which is lower than the RMB 212,676 (USD 30,778) willingness-to-pay threshold of three times Gross Domestic Product. This conclusion is sensitive to the mortality for patients with no severe CVD events, the incidence of CVD events, and the cost of HP and HD. At a willingness-to-pay threshold of RMB 212,676 (USD 30,778) per QALY gained, the probability that HD + HP is cost-effective is 58%. CONCLUSIONS: Our results indicate a potential for HD + HP to be cost-effective for patients with ESRD. Further evidence on the longer-term impact of HD + HP on CVD event rates and mortality unrelated to CVD is needed to robustly demonstrate the cost-effectiveness of HD + HP. TRIAL REGISTRATION: The HD/HP trial was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-16009332).
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Idioma: En Revista: Ann Transl Med Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: China
Texto completo
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Imprimir
XML
PubMed Links
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials / Health_economic_evaluation Aspecto: Patient_preference Idioma: En Revista: Ann Transl Med Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: China