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PLoS One. 2019 Aug 15;14(8):e0220800. doi: 10.1371/journal.pone.0220800. eCollection 2019.

Healthcare costs of patients on different renal replacement modalities - Analysis of Dutch health insurance claims data.

Author information

1
Centre for Nutrition, Prevention and Health Services, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
2
Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.
3
Erasmus School of Health Policy & Management (ESHPM), Institute for Medical Technology Assessment (iMTA), Erasmus University, Rotterdam, The Netherlands.
4
Dutch Renal Registry Renine, Nefrovisie Foundation, Utrecht, The Netherlands.
5
Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands.
6
Juliuscentre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands.

Abstract

BACKGROUND:

The aim of this study is to present average annual healthcare costs for Dutch renal replacement therapy (RRT) patients for 7 treatment modalities.

METHODS:

Health insurance claims data from 2012-2014 were used. All patients with a 2014 claim for dialysis or kidney transplantation were selected. The RRT related and RRT unrelated average annual healthcare costs were analysed for 5 dialysis modalities (in-centre haemodialysis (CHD), home haemodialysis (HHD), continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and multiple dialysis modalities in a year (Mix group)) and 2 transplant modalities (kidney from living and deceased donor, respectively).

RESULTS:

The total average annual healthcare costs in 2014 ranged from €77,566 (SD = €27,237) for CAPD patients to €105,833 (SD = €30,239) for patients in the Mix group. For all dialysis modalities, the vast majority (72-84%) of costs was RRT related. Patients on haemodialysis ≥4x/week had significantly higher average annual costs compared to those dialyzing 3x/week (Δ€19,122). Costs for kidney transplant recipients were €85,127 (SD = €39,679) in the year of transplantation and rapidly declined in the first and second year after successful transplantation (resp. €29,612 (SD = €34,099) and €15,018 (SD = €16,186)). Transplantation with a deceased donor kidney resulted in higher costs (€99,450, SD = €36,036)) in the year of transplantation compared to a living donor kidney transplantation (€73,376, SD = €38,666).

CONCLUSIONS:

CAPD patients have the lowest costs compared to other dialysis modalities. Costs in the year of transplantation are 25% lower for patients with kidneys from living vs. deceased donor. After successful transplantation, annual costs decline substantially to a level that is approximately 14-19% of annual dialysis costs.

Conflict of interest statement

The authors have declared that no competing interests exist.

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