Economic evaluation of renal replacement therapy strategies in Moscow


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Abstract

Objective. assessment of the economic and clinical impact of an increase in the number and frequency of kidney transplantation in Moscow on patients with chronic kidney disease (CKD) who require renal replacement therapy (RRT). material and methods. within the framework of this study, we compared two strategies for providing rrt for patients on hemodialysis in Moscow, which differ in the frequency and number of kidney transplantation. cost-effectiveness and cost-benefit analyzes were performed using the Markov model, which included three states: hemodialysis, the presence of a kidney transplant, and death. the simulated population consists of adult Moscow patients starting rrt. the developed model takes into account direct medical and direct non-medical costs. the effectiveness of the strategies was measured by life years, quality-adjusted life years. Costs and efficiencies were discounted at a rate of 5%. In order to check the robustness of the results, a scenario analysis was carried out. results. the results of the study showed that increasing the frequency of kidney transplantation is the dominant strategy. Within the ten-year horizon of modeling, the costs per patient in current practice and expected practice amounted to 9,259,950 and 8,849,426 rubles, respectively. at the same time, the number of accumulated life years per patient was 5.16 and 3.27 quality-adjusted life years for the expected practice, and 4.93 and 3.00 - for the current practice, respectively. scenario analysis confirmed the robustness of the results. Conclusion. An increase in the frequency of kidney transplantation among CKD patients in Moscow is likely to have a positive impact on the life expectancy of these patients with reducing the financial burden on the healthcare system.

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About the authors

Artem A. Antonov

Center for Healthcare Quality Assessment and Control of Medical Care of the Ministry of Health of the Russian Federation

Email: antonov@rosmedex.ru
Leading Specialist of the Department of Methodological Support for Comprehensive Health Technology Assessment Moscow, Russia

Tatyana P. Bezdenezhnykh

Center for Healthcare Quality Assessment and Control of Medical Care of the Ministry of Health of the Russian Federation; Financial Research Institute of the Ministry of Finance of the Russian Federation

Email: bezdenezhnyh@rosmedex.ru
Leading Specialist at the Department of Methodological Support for Comprehensive Health Technology Assessment; Junior Researcher Moscow, Russia; Moscow, Russia

Anna A. Trifonova

Center for Healthcare Quality Assessment and Control of Medical Care of the Ministry of Health of the Russian Federation

Email: trifonova@rosmedex.ru
Chief Specialist at the Department of Methodological Support for Comprehensive Health Technology Assessment Moscow, Russia

Oleg N. Kotenko

Moscow City Scientific and Practical Center for Nephrology and Transplanted Kidney Pathology City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: olkotenko@yandex.ru
Cand. Sci. (Med.), Chief External Expert in Nephrology of the Moscow Healthcare Department, Head of the Moscow Scientific and Practical Moscow, Russia

Vitaly V. Omelyanovskiy

Center for Healthcare Quality Assessment and Control of Medical Care of the Ministry of Health of the Russian Federation; Financial Research Institute of the Ministry of Finance of the Russian Federation; Russian Medical Academy of Continuous Professional Education

Email: vitvladom@gmail.com
r. Sci. (Med.), Professor; General Director; Head of the Center for Healthcare Funding; Head of the Department of Healthcare Economics, Management and Technology Assessment Moscow, Russia; Moscow, Russia; Moscow, Russia

Nuria Z. Musina

Center for Healthcare Quality Assessment and Control of Medical Care of the Ministry of Health of the Russian Federation; Financial Research Institute of the Ministry of Finance of the Russian Federation; St. Petersburg State Chemical Pharmaceutical University

Email: nuriyamusina@gmail.com
Cand. Sci. (Pharm.), Associate Professor at the Department of Management and Economics of Pharmacy; Head of the Department for Development and External Communications; Senior Researcher Moscow, Russia; Moscow, Russia; St. Petersburg, Russia

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