Charles Darwin University

CDU eSpace
Institutional Repository

 
CDU Staff and Student only
 

Economic Evaluation of Neutral-pH, Low-Glucose Degradation Product Peritoneal Dialysis Solutions Compared with Standard Solutions: A Secondary Analysis of the balANZ Trial

Howard, Kirsten, Hayes, Alison, Cho, Yeoungjee, Cass, Alan, Clarke, Margaret and Johnson, David (2015). Economic Evaluation of Neutral-pH, Low-Glucose Degradation Product Peritoneal Dialysis Solutions Compared with Standard Solutions: A Secondary Analysis of the balANZ Trial. American Journal of Kidney Diseases,65(5):773-779.

Document type: Journal Article
Citation counts: Altmetric Score Altmetric Score is 2
Google Scholar Search Google Scholar

IRMA ID 75039815xPUB854
Title Economic Evaluation of Neutral-pH, Low-Glucose Degradation Product Peritoneal Dialysis Solutions Compared with Standard Solutions: A Secondary Analysis of the balANZ Trial
Author Howard, Kirsten
Hayes, Alison
Cho, Yeoungjee
Cass, Alan
Clarke, Margaret
Johnson, David
Journal Name American Journal of Kidney Diseases
Publication Date 2015
Volume Number 65
Issue Number 5
ISSN 0272-6386   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84929029134
Start Page 773
End Page 779
Total Pages 7
Place of Publication United States
Publisher W.B. Saunders Co.
HERDC Category C1 - Journal Article (DIISR)
Abstract Background
Biocompatible solutions may lower peritonitis rates, but are more costly than conventional solutions. The aim of the present study was to assess the additional costs and health outcomes of biocompatible over conventional solutions in incident peritoneal dialysis patients to guide practice decisions.

Study Design
Secondary economic evaluation of a randomized controlled trial.

Setting & Population

185 participants in the balANZ trial.

Model, Perspective, & Timeframe
Cost-effectiveness of biocompatible compared to standard solution over the 2 years using an Australian health care funder perspective.

Intervention

Intervention group received biocompatible solutions and control group received standard solutions over 2 years.

Outcomes

Costs included dialysis charges, costs of treating peritonitis, non−peritonitis-related hospital stays, and medication. Peritonitis was the health outcome of interest; incremental cost-effectiveness ratios were reported in terms of the additional cost per additional patient avoiding peritonitis at 2 years.

Results
Mean total per-patient costs were A$57,451 and A$53,930 for the biocompatible and standard-solution groups, respectively. The base-case analysis indicated an incremental cost of A$17,804 per additional patient avoiding peritonitis at 2 years for biocompatible compared to standard solution. In a sensitivity analysis excluding extreme outliers for non−peritonitis-related hospitalizations, mean per-patient costs were A$49,159 and A$52,009 for the biocompatible and standard-solution groups, respectively. Consequently, the incremental cost-effectiveness ratio also was reduced significantly: biocompatible solution became both less costly and more effective than standard solution and, in economic terms, was dominant over standard solution.

Limitations
Peritonitis was a secondary outcome of the balANZ trial. Health outcomes measured only in terms of patients avoiding peritonitis over 2 years may underestimate the longer term benefits (eg, prolonged technique survival).

Conclusions
Biocompatible dialysis solutions may offer a cost-effective alternative to standard solutions for peritoneal dialysis patients. Reductions in peritonitis-related hospital costs may offset the higher costs of biocompatible solution.
DOI http://dx.doi.org/10.1053/j.ajkd.2014.12.017   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
 
Versions
Version Filter Type
Access Statistics: 7 Abstract Views  -  Detailed Statistics
Created: Tue, 26 Jul 2016, 12:52:18 CST