Back
Expanded hemodialysis (HDx) enabled by medium cut-off dialyzers, has been shown to increase the efficacy of clearance of medium molecules, compared to hemodialysis based on high-flux dialyzers (HF HD). Additional evidence for the effectiveness of HDx has emerged, as this intervention reduces the rate of hospitalization and the incidence of non-fatal cardiovascular events compared to HF HD.
The objective of this study was to conduct an economic analysis that estimates the economic impact of the improvements provided by HDx over HF HD in the context of the Colombian healthcare system.
This study estimated the budgetary impact of using a medium-cut membrane compared to HF membrane in the Colombian health system using data from the sufficiency database of the Capitation Payment Unit (UPC) 2019 (Colombian ministry of health). A difference-in-differences analysis was used to estimate the magnitude of the effect attributable to the use of this dialyzer. In addition, we conducted an analysis of hospitalization costs and estimated the prevalence of hospitalizations among hemodialysis patients within the Colombian health system, utilizing publicly available population data. The analysis perspective was the third payor, and we used an approach of dialysis bundle assuming the same price per patient per month for HF HD and HDx, in a 10% market share scenario for Theranova; we used a decision tree model.
In the study, patients on hemodialysis with high-flux dialyzers registered an average of 1.3 hospitalizations per year, while those treated with expanded HDx enabled by Theranova dialyzers showed a reduction of 0.3 hospitalizations per patient-year. Extrapolating to the entire HD population in Colombia, the annual number of hospitalizations for patients on HF HD averages 3.7; therefore, the reduction in the number of hospitalizations could reach 0.9 episodes per patient-year. The average cost of hospitalization for a patient requiring hemodialysis is $3,132,115 Colombian pesos in 2023. Of these hospitalizations, 24% had a duration of one day, 19% lasted between 2 and 5 days, 22% lasted between 6 and 10 days, and the remaining had a stay exceeding 10 days. Then HDx has the potential of cost savings ranging from 992,353.00 Colombian pesos to 3,758,041.00 per patient per year. Details of the decision tree model are presented in Figure 1.
The use of HDx enabled by Theranova membranes can have a positive impact on the Colombian healthcare system, generating savings resulting from the reduction in the number of hospitalizations.