Health economic evaluations: The special case of end-stage renal disease treatment
Health economic evaluations: The special case of end-stage renal disease treatment
复制标题
DOI：
10.1177/027298902236927
复制
发表时间：
2002-09-01
影响因子：
3.6
通讯作者：
Pliskin, JS
中科院分区：
文献类型：
--
作者：
Winkelmayer, WC;Weinstein, MC;Pliskin, JS
本文综合了肾脏替代治疗的成本-效果的证据，并根据经常使用血液透析的成本-效果作为社会支付意愿基准的实践，讨论了研究结果。作者对血液透析、腹膜透析和肾移植的经济评估的医学和经济文献进行了荟萃分析综述。成本效益比被转换为每生命年（LY）节省2000美元。1968年至1998年期间发表的13份研究报告提供了这类资料。在大多数研究中，中心血液透析的成本效益保持在55，000美元至80，000美元/LY的狭窄范围内，尽管方法和估算成本存在相当大的差异。家庭血液透析的成本效益在33，000美元至50，000美元/LY之间。然而，随着时间的推移，肾移植已经变得更具成本效益，接近10，000美元/LY。在过去的30年里，根据价格水平调整后，血液透析获得的每生命年成本估计值非常稳定。使用中心血液透析的成本效益比55，000美元/LY作为社会愿意支付额外生命年的下限，在某些假设下可以得到支持。
This article synthesizes the evidence on the cost-effectiveness of renal replacement therapy and discusses the findings in light of the frequent practice of using the cost-effectiveness of hemodialysis as a benchmark of societal willingness to pay. The authors conducted a meta-analytic review of the medical and economic literature for economic evaluations of hemodialysis, peritoneal dialysis, and kidney transplantation. Cost-effectiveness ratios were translated into 2000 U.S. dollars per life-year (LY) saved. Thirteen studies published between 1968 and 1998 provided such information. The cost-effectiveness of center hemodialysis remained within a narrow range of $55,000 to $80,000/LY in most studies despite considerable variation in methodology and imputed costs. The cost-effectiveness of home hemodialysis was found to be between $33,000 and $50,000/LY. Kidney transplantation, however, has become more cost-effective over time, approaching $10,000/LY Estimates of the cost per life-year gained from hemodialysis have been remarkably stable over the past 3 decades, after adjusting for price levels. Uses of the cost-effectiveness ratio of $55,000/LY for center hemodialysis as a lower boundary of society's willingness to pay for an additional life-year can be supported under certain assumptions.