Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study

Renee Lévesque; Daniele Marcelli; Héloïse Cardinal; Marie Line Caron; Muriel P C Grooteman; Michiel L. Bots; Peter J. Blankestijn; Menso J. Nubé; Aileen Grassmann; Bernard Canaud; Afschin Gandjour

doi:10.1007/s40258-015-0179-0

Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study

Renee Lévesque, Daniele Marcelli^*, Héloïse Cardinal, Marie Line Caron, Muriel P C Grooteman, Michiel L. Bots, Peter J. Blankestijn, Menso J. Nubé, Aileen Grassmann, Bernard Canaud, Afschin Gandjour

^*Corresponding author for this work

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Abstract

Aim: The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OL-HDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l’Université de Montréal) 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.

Original language	English
Pages (from-to)	647-659
Journal	Applied Health Economics and Health Policy
Volume	13
Issue number	6
DOIs	https://doi.org/10.1007/s40258-015-0179-0
Publication status	Published - Dec 2015

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Lévesque, R., Marcelli, D., Cardinal, H., Caron, M. L., Grooteman, M. P. C., Bots, M. L., Blankestijn, P. J., Nubé, M. J., Grassmann, A., Canaud, B., & Gandjour, A. (2015). Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study. Applied Health Economics and Health Policy, 13(6), 647-659. https://doi.org/10.1007/s40258-015-0179-0

@article{70052a63618540a7805fb7eae3c57492,

title = "Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study",

abstract = "Aim: The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OL-HDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l{\textquoteright}Universit{\'e} de Montr{\'e}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.",

author = "Renee L{\'e}vesque and Daniele Marcelli and H{\'e}lo{\"i}se Cardinal and Caron, {Marie Line} and Grooteman, {Muriel P C} and Bots, {Michiel L.} and Blankestijn, {Peter J.} and Nub{\'e}, {Menso J.} and Aileen Grassmann and Bernard Canaud and Afschin Gandjour",

year = "2015",

month = dec,

doi = "10.1007/s40258-015-0179-0",

language = "English",

volume = "13",

pages = "647--659",

journal = "Applied Health Economics and Health Policy",

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Lévesque, R, Marcelli, D, Cardinal, H, Caron, ML, Grooteman, MPC, Bots, ML, Blankestijn, PJ, Nubé, MJ, Grassmann, A, Canaud, B & Gandjour, A 2015, 'Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study', Applied Health Economics and Health Policy, vol. 13, no. 6, pp. 647-659. https://doi.org/10.1007/s40258-015-0179-0

Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study. / Lévesque, Renee; Marcelli, Daniele; Cardinal, Héloïse et al.
In: Applied Health Economics and Health Policy, Vol. 13, No. 6, 12.2015, p. 647-659.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study

AU - Lévesque, Renee

AU - Marcelli, Daniele

AU - Cardinal, Héloïse

AU - Caron, Marie Line

AU - Grooteman, Muriel P C

AU - Bots, Michiel L.

AU - Blankestijn, Peter J.

AU - Nubé, Menso J.

AU - Grassmann, Aileen

AU - Canaud, Bernard

AU - Gandjour, Afschin

PY - 2015/12

Y1 - 2015/12

N2 - Aim: The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OL-HDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l’Université de Montréal) 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.

AB - Aim: The aim of this study was to assess the cost effectiveness of high-efficiency on-line hemodiafiltration (OL-HDF) compared with low-flux hemodialysis (LF-HD) for patients with end-stage renal disease (ESRD) based on the Canadian (Centre Hospitalier de l’Université de Montréal) 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.

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JO - Applied Health Economics and Health Policy

JF - Applied Health Economics and Health Policy

IS - 6

ER -

Cost-Effectiveness Analysis of High-Efficiency Hemodiafiltration Versus Low-Flux Hemodialysis Based on the Canadian Arm of the CONTRAST Study

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