Is home hemodialysis feasible for Colombia? Cost-utility perspective.

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E-Poster

https://storage.unitedwebnetwork.com/files/1099/3147905f66b17a10aeaf5a7c8c9fdf13.pdf

Abstract Title

First Name *

Camilo

Last Name *

Gonzalez

Co-author 1

Edna Zambrano ed_zambrano@javeriana.edu.co Pontificia Universidad Javeriana Economía de la salud Bogota

Co-author 2

Dario Londoño dario.londono@gmail.com Fundación Santa Fe Salud publica Bogota

Co-author 3

Julian Serrano serrano.julian@javeriana.edu.co Pontificia Universidad Javeriana Medicina Bogota

Co-author 4

Co-author 5

Co-author 6

Co-author 7

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Home hemodialysis (HHD) has not yet been adopted in Latin America. Fortunately, peritoneal dialysis (DP) is extensively used in Colombia as a cost-effective policy. However, in patients without option of DP, despite foreign data indicating HHD's cost-effectiveness compared to in center hemodialysis (HD), the low cost of conventional HD limit the introduction of HHD.

Methods

To determine the incremental cost-effectiveness ratio of HHD compared with HD in patients with home peritoneal dialysis contraindication or peritoneal membrane failure in Colombia. A Markov model was developed to assess the costs and health-related quality-adjusted life years (QALYs) of HHD compared to HD from the perspective of the Colombian healthcare system (direct medical costs) over a 5-year time horizon. Sensitivity analysis was performed with the effectiveness data, costs, and discount rates. Colombian pesos (COP) exchange to United States dollars (USD) was performed with an average rate of exchange during 2022 (1 USD = 4255.44) based on the official report of the Republic Bank of Colombia.

Results

In the probabilistic analysis, HHD was associated with incremental costs of COP 110.333.580 (USD 25.927.6) and 0.31 QALYs, resulting in an incremental cost-effectiveness ratio of COP 351.816.435 (USD 82.674.5).

Conclusions

HHD does not appear to be cost-effective compared with HD from the perspective of a third-party payer in Colombia. However, an evaluation from a societal perspective is required to consider the reduction in indirect costs associated with HHD.

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