Economic Evaluation of Frequent Home Nocturnal Hemodialysis Based on a Randomized Controlled Trial
Key result
Frequent home nocturnal hemodialysis saves ~$6,700 and improves quality-adjusted life years versus conventional hemodialysis.
- savings of $6700 and 0.38 additional QALYs
Why the study?
The cost-effectiveness of frequent home nocturnal hemodialysis compared with conventional hemodialysis was unknown.
Does frequent home nocturnal hemodialysis improve cost-effectiveness compared to conventional hemodialysis in patients requiring dialysis?
Population
Patients requiring hemodialysis from the Alberta NHD randomized controlled trial
Comparison
Frequent home nocturnal hemodialysis vs conventional hemodialysis (4 hours three times per week)
Design
Cost-utility analysis based on randomized controlled trial data from a health payer perspective
Follow-up
Lifetime horizon
Authors
Discussion
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Implication
Supports cost-effectiveness of frequent home nocturnal hemodialysis; leaves open real-world applicability given sensitivity to failure rates and training.
Structured PICO
Does frequent home nocturnal hemodialysis improve cost-effectiveness compared to conventional hemodialysis in patients requiring dialysis?
P
Population
Patients requiring hemodialysis from the Alberta NHD randomized controlled trial evaluated over a lifetime horizon.
I
Intervention
Frequent home nocturnal hemodialysis (FHNHD)
C
Comparator
Conventional hemodialysis (CvHD; 4 hours three times per week, comprising 61% in-center, 14% satellite, and 25% home dialysis)
O
Outcome
Incremental cost per quality-adjusted life year (QALY) gained over a lifetime horizon
Main Result
Effect estimate: savings of $6700 and 0.38 additional QALYs
Frequent home nocturnal hemodialysis is economically attractive compared with in-center conventional hemodialysis, though its cost-effectiveness is sensitive to technique failure rates and training times.
Limitations
- Attractiveness of FHNHD varies by technique failure rate, training time, and dialysis modalities from which patients are drawn
Cite This Study
Klarenbach et al. (2013) studied Hemodialysis. Frequent home nocturnal hemodialysis (FHNHD) vs. Conventional hemodialysis (CvHD; 4 hours three times per week) was evaluated on Incremental cost per quality-adjusted life year (QALY) gained (savings of $6700 and 0.38 additional QALYs). Compared with conventional hemodialysis, frequent home nocturnal hemodialysis led to incremental cost savings of $6,700 and an additional 0.38 quality-adjusted life years.