Examining alternative End-Stage Renal Disease (ESRD) therapies through simulation

To examine the costs and effects of alternative treatments for End-Stage Renal Disease (ESRD), we constructed a simulation model which estimates patient survival and lifetime cost for those with ESRD. The model, written in the INS simulation language, considers home and center hemodialysis as well as live related and cadaver donor transplantation. After the model was validated, the cost per life year gained for each therapy was computed. Center hemodialysis was found to have the poorest cost-effectiveness and shifts from center hemodialysis could save society up to 284 million annually. We conclude that the model may be very helpful in designing cost-effective care for End-Stage Renal Disease.