TY - JOUR
T1 - Healthcare costs of patients on different renal replacement modalities
T2 - Analysis of Dutch health insurance claims data
AU - Mohnen, Sigrid M
AU - van Oosten, Manon J M
AU - Los, Jeanine
AU - Leegte, Martijn J H
AU - Jager, Kitty J
AU - Hemmelder, Marc H
AU - Logtenberg, Susan J J
AU - Stel, Vianda S
AU - Hakkaart-van Roijen, Leona
AU - de Wit, G Ardine
N1 - Funding Information:
This work is financed by a grant from the Dutch Kidney Foundation to National Institute of Public Health and the Environment and the Institute of Medical Technology Assessment of Erasmus University Rotterdam. The authors thank Vektis for providing access to the health claims data and for assisting with their comprehensive knowledge regarding analysis of health insurance claims data. We thank Nefrovisie, the national quality agency for the treatment of kidney diseases and RENINE, the Dutch Registry of RRT treatment, for providing Registry data for the validation of VEKTIS data. We thank dr. Cecile Couchoud for sharing her insights on the attribution of patients to different treatment groups. We are grateful to Henk Bilo, Manon Lette, and Peter Kemper for the critical reading of a draft version of this article.
Publisher Copyright:
© 2019 Mohnen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2019/8/15
Y1 - 2019/8/15
N2 - BACKGROUND: The aim of this study is to present average annual healthcare costs for Dutch renal replacement therapy (RRT) patients for 7 treatment modalities.METHODS: Health insurance claims data from 2012-2014 were used. All patients with a 2014 claim for dialysis or kidney transplantation were selected. The RRT related and RRT unrelated average annual healthcare costs were analysed for 5 dialysis modalities (in-centre haemodialysis (CHD), home haemodialysis (HHD), continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and multiple dialysis modalities in a year (Mix group)) and 2 transplant modalities (kidney from living and deceased donor, respectively).RESULTS: The total average annual healthcare costs in 2014 ranged from €77,566 (SD = €27,237) for CAPD patients to €105,833 (SD = €30,239) for patients in the Mix group. For all dialysis modalities, the vast majority (72-84%) of costs was RRT related. Patients on haemodialysis ≥4x/week had significantly higher average annual costs compared to those dialyzing 3x/week (Δ€19,122). Costs for kidney transplant recipients were €85,127 (SD = €39,679) in the year of transplantation and rapidly declined in the first and second year after successful transplantation (resp. €29,612 (SD = €34,099) and €15,018 (SD = €16,186)). Transplantation with a deceased donor kidney resulted in higher costs (€99,450, SD = €36,036)) in the year of transplantation compared to a living donor kidney transplantation (€73,376, SD = €38,666).CONCLUSIONS: CAPD patients have the lowest costs compared to other dialysis modalities. Costs in the year of transplantation are 25% lower for patients with kidneys from living vs. deceased donor. After successful transplantation, annual costs decline substantially to a level that is approximately 14-19% of annual dialysis costs.
AB - BACKGROUND: The aim of this study is to present average annual healthcare costs for Dutch renal replacement therapy (RRT) patients for 7 treatment modalities.METHODS: Health insurance claims data from 2012-2014 were used. All patients with a 2014 claim for dialysis or kidney transplantation were selected. The RRT related and RRT unrelated average annual healthcare costs were analysed for 5 dialysis modalities (in-centre haemodialysis (CHD), home haemodialysis (HHD), continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and multiple dialysis modalities in a year (Mix group)) and 2 transplant modalities (kidney from living and deceased donor, respectively).RESULTS: The total average annual healthcare costs in 2014 ranged from €77,566 (SD = €27,237) for CAPD patients to €105,833 (SD = €30,239) for patients in the Mix group. For all dialysis modalities, the vast majority (72-84%) of costs was RRT related. Patients on haemodialysis ≥4x/week had significantly higher average annual costs compared to those dialyzing 3x/week (Δ€19,122). Costs for kidney transplant recipients were €85,127 (SD = €39,679) in the year of transplantation and rapidly declined in the first and second year after successful transplantation (resp. €29,612 (SD = €34,099) and €15,018 (SD = €16,186)). Transplantation with a deceased donor kidney resulted in higher costs (€99,450, SD = €36,036)) in the year of transplantation compared to a living donor kidney transplantation (€73,376, SD = €38,666).CONCLUSIONS: CAPD patients have the lowest costs compared to other dialysis modalities. Costs in the year of transplantation are 25% lower for patients with kidneys from living vs. deceased donor. After successful transplantation, annual costs decline substantially to a level that is approximately 14-19% of annual dialysis costs.
UR - http://www.scopus.com/inward/record.url?scp=85070711324&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0220800
DO - 10.1371/journal.pone.0220800
M3 - Article
C2 - 31415578
SN - 1932-6203
VL - 14
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - e0220800
ER -