dc.date.accessioned | 2018-02-13T13:15:32Z | |
dc.date.available | 2018-02-13T13:15:32Z | |
dc.date.created | 2017-01-23T15:37:15Z | |
dc.date.issued | 2017 | |
dc.identifier.citation | Pike, Eva Hamidi, Vida Ringerike, Tove Wisløff, Torbjørn Klemp, Marianne . More Use of Peritoneal Dialysis Gives Significant Savings: A Systematic Review and Health Economic Decision Model. Journal of Clinical Medicine Research. 2017, 9(2), 104-116 | |
dc.identifier.uri | http://hdl.handle.net/10852/60066 | |
dc.description.abstract | Background: Patients with end-stage renal disease (ESRD) are in need of renal replacement therapy as dialysis and/or transplantation. The prevalence of ESRD and, thus, the need for dialysis are constantly growing. The dialysis modalities are either peritoneal performed at home or hemodialysis (HD) performed in-center (hospital or satellite) or home. We examined effectiveness and cost-effectiveness of HD performed at different locations (hospital, satellite, and home) and peritoneal dialysis (PD) at home in the Norwegian setting.
Methods: We conducted a systematic review for patients above 18 years with end-stage renal failure requiring dialysis in several databases and performed several meta-analyses of existing literature. Mortality and major complications that required were our main clinical outcomes. The quality of the evidence for each outcome was evaluated using GRADE. Cost-effectiveness was assessed by developing a probabilistic Markov model. The analysis was carried out from a societal perspective, and effects were expressed in quality-adjusted life-years. Uncertainties in the base-case parameter values were explored with a probabilistic sensitivity analysis. Scenario analyses were conducted by increasing the proportion of patients receiving PD with a corresponding reduction in HD patients in-center both for Norway and Europian Union. We assumed an annual growth rate of 4% in the number of dialysis patients, and a relative distribution between PD and HD in-center of 30% and 70%, respectively.
Results: From a societal perspective and over a 5-year time horizon, PD was the most cost-effective dialysis alternative. We found no significant difference in mortality between peritoneal and HD modalities. Our scenario analyses showed that a shift toward more patients on PD (as a first choice) with a corresponding reduction in HD in-center gave a saving over a 5-year period of 32 and 10,623 million EURO, respectively, for Norway and the European Union.
Conclusions: PD was the most cost-effective dialysis alternative and was comparable with HD regarding efficacy outcomes. There are significant saving potentials if more end-stage renal patients are started on PD instead of HD. | en_US |
dc.language | EN | |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 Unported | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/3.0/ | |
dc.title | More Use of Peritoneal Dialysis Gives Significant Savings: A Systematic Review and Health Economic Decision Model | en_US |
dc.type | Journal article | en_US |
dc.creator.author | Pike, Eva | |
dc.creator.author | Hamidi, Vida | |
dc.creator.author | Ringerike, Tove | |
dc.creator.author | Wisløff, Torbjørn | |
dc.creator.author | Klemp, Marianne | |
cristin.unitcode | 185,53,18,15 | |
cristin.unitname | Avdeling for farmakologi | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 0 | |
dc.identifier.cristin | 1435721 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal of Clinical Medicine Research&rft.volume=9&rft.spage=104&rft.date=2017 | |
dc.identifier.jtitle | Journal of Clinical Medicine Research | |
dc.identifier.volume | 9 | |
dc.identifier.issue | 2 | |
dc.identifier.startpage | 104 | |
dc.identifier.endpage | 116 | |
dc.identifier.doi | http://dx.doi.org/10.14740/jocmr2817w | |
dc.identifier.urn | URN:NBN:no-62727 | |
dc.type.document | Tidsskriftartikkel | en_US |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 1918-3003 | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/60066/1/Pike_2017.pdf | |
dc.type.version | PublishedVersion | |