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Full bibliographic referencede Wit GA, Ramsteijn PG, de Charro FT (1998) Economic evaluation of end stage renal disease treatment. Health Policy 44: 215–32.
Source of fundingNot stated
Economic study typeCost utility analysis modeling the future of the Dutch ERSD programme and how future patients should be allocated to different modalities
Population, Country and perspectiveNetherlands ESRD patients
Comparison(s)Current provision (CHD, LCHD, HHD, CAPD, CCPD, Tx)
Increasing transplantation to 34 per million and 44 per million
Shifting CHD to LCHD (10% and 20%)
CHD to CAPD (10% and 20%)
CHD to CCPD (10% and 20%)
Source of effectiveness dataA clinical study – NECOSAD (n = 165) and 30 extra CCPD patients due to low number
Cost componentsNECOSAD trial and from local hospitals
Time horizon, discount rate5 years
Results – costTotal cost of Dutch ESRD program of 3240312000 Dutch gilders
Tx to 34: −25,531,800
Tx to 44: −59,267,900
10% CHD to LCHD: +12,694,500
20% CHD to LCHD: +25,402,900
10% CHD to CAPD: −9,421,100
20% CHD to CAPD: −18,886,200
10% CHD to CCPD: +80,000
20% CHD to CCPD: +128,000
Results – effectivenessTotal LYG and QALYs of Dutch ESRD program of 41149
LYG and 32955 QALYs
Tx to 34: 43/102
Tx to 44: 100/238
10% CHD to LCHD: 140/168
20% CHD to LCHD: 281/337
10% CHD to CAPD: 85/81
20% CHD to CAPD: 170/162
10% CHD to CCPD: 72/109
20% CHD to CCPD: 144/219
Results – adverse eventsNone states
Results – Incremental cost-effectivenessBaseline – 98323
Tx to 34: −1076
Tx to 44: −2491
10% CHD to LCHD: −116
20% CHD to LCHD: −231
10% CHD to CAPD: −525
20% CHD to CAPD: −1050
10% CHD to CCPD: −323
20% CHD to CCPD: −646
Results – UncertaintyChanges to QoL estimation of SG, TTO increase QALYs and reduces ICER
Authors’ conclusionsConsiderable saving are possible if health care systems would shift treatment over to PD
General commentsThe analysis is of good structure, but due to its age and changes in technology and therefore needs to be updated and made to specifically examine UK population

From: Appendix B, Health economics

Cover of Peritoneal Dialysis
Peritoneal Dialysis: Peritoneal Dialysis in the Treatment of Stage 5 Chronic Kidney Disease.
NICE Clinical Guidelines, No. 125.
Centre for Clinical Practice at NICE (UK).
Copyright © 2011, National Institute for Health and Clinical Excellence.

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