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Titolo Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study
Autore Renee Levesque, Daniele Marcelli, Heloise Cardinal, Marie-Line Caron, Muriel P. C. Grooteman, Michiel L. Bots, Peter J. Blankestijn, Menso J. Nubé, Aileen Grassmann, Bernard Canaud, Afschin Gandjour
Referenza Appl Health Econ Health Policy,2015 - DOI: 10.1007/s40258-015-0179-0

Aim. The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OLHDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l’Universite´ de Montre´al) arm of a parallel-group randomized controlled trial (RCT), the CONvective TRAnsport STudy.

Methods. An economic evaluation was conducted for the period of the RCT (74 months). In addition, a Markov state transition model was constructed to simulate costs and health benefits over lifetime. The primary outcome was costs per quality-adjusted life-year (QALY) gained. The analysis had the perspective of the Quebec public healthcare system.

Results. A total of 130 patients were randomly allocated to OL-HDF (n = 67) and LF-HD (n = 63). The cost-utility ratio of OL-HDF versus LF-HD was Can$53,270 per QALY gained over lifetime. This ratio was fairly robust in the sensitivity analysis. The cost-utility ratio was lower than that of LF-HD compared with no treatment (immediate death), which was Can$93,008 per QALY gained.

Conclusions. High-efficiency OL-HDF can be considered a cost-effective treatment for ESRD in a Canadian setting. Further research is needed to assess cost effectiveness in other settings and healthcare systems.

Data 22.06.2015
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