IJCM  Vol.7 No.7 , July 2016
Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia
Abstract: End-Stage Renal Disease (ESRD) represents one of the most challenging social and medical problems mainly due to substantial treatment-associated costs. The chronic nature of the disease needs expensive continuous care that majority of the patients cannot afford. Therefore, in many countries expenses associated with the ESRD treatment is paid by state government. These treatment options include: hemodialysis, peritoneal dialysis and kidney transplantation. Multiple studies have been conducted throughout the world to assess cost-effectiveness of these treatment modalities. The studies suggest that kidney transplantation not only reduces mortality and morbidity but improves a quality of life of ESRD patients. Furthermore, it is the most cost-effective treatment for the ESRD at least in high-income countries. The goal of our study was to determine whether above-mentioned is true for lower middle income countries, where the cost of the ESRD treatment is substantially lower. Despite the low dialysis costs, transplantation remains the cheapest form of renal replacement therapy RRT in lower income countries like Georgia. Our results reveal, that kidney transplantation is most expensive modality of Renal Replacement Therapy (RRT) at month 1, but count of costs reveals that after the 10th month of treatment, the cumulative cost of transplantation is less than the cumulative cost of peritoneal dialysis and after the 23rd month, cumulative cost of hemodialysis also surpasses the cumulative cost of transplantation-related treatment and this cost comparison is in line with global data from upper-middle and high income countries.
Cite this paper: Tataradze, A. , Managadze, G. , Beglarashvili, L. , Kipshidze, N. , Managadze, L. and Chkhotua, A. (2016) Comparative Costs of Different Renal Replacement Therapies in Lower Middle Income Countries on the Example of Georgia. International Journal of Clinical Medicine, 7, 437-444. doi: 10.4236/ijcm.2016.77046.

[1]   End Stage Renal Disease in the United States. National Kidney Foundation.

[2]   Meguid El Nahas, A and Bello, A.K. (2005) Chronic Kidney Disease: The Global Challenge. The Lancet, 365, 331-340.

[3]   USRDS Annual Data Report (2011) Costs of ESRD.

[4]   Barsoum, R.S. (2006) Chronic Kidney Disease in the Developing World. The New England Journal of Medicine, 354, 997-999.

[5]   Dor, A., Pauly, M.V., Eichleay, M.A. and Held, P.J. (2007) End-Stage Renal Disease and Economic Incentives: The International Study of Health Care Organization and Financing (ISHCOF). International Journal of Health Care Finance and Economics, 7, 73-111.

[6]   Haller, M., Gutjahr, G., Kramar, R., Harnoncourt, F. and Oberbauer, R. (2011) Cost-Effectiveness Analysis of Renal Replacement Therapy in Austria. Nephrology Dialysis Transplantation, 26, 2988-2995.

[7]   Jensen, C.E., Sørensen, P. and Petersen, K.D. (2014) In Denmark Kidney Transplantation Is More Cost-Effective than Dialysis. Danish Medical Journal, 61, A4796.

[8]   Perovic, S. and Jankovic, S. (2009) Renal Transplantation vs Hemodialysis: Cost-Effectiveness Analysis. Vojnosanitetski Pregled, 66, 639-644.

[9]   Sánchez-Escuredo, A., Alsina, A., Diekmann, F., et al. (2015) Economic Analysis of the Treatment of End-Stage Renal Disease Treatment: Living-Donor Kidney Transplantation versus Hemodialysis. Transplantation Proceedings, 47, 30-33.

[10]   Howard, K., Salkeld, G., White, S., McDonald, S., Chadban, S., Craig, J.C. and Cass, A. (2009) The Cost-Effectiveness of Increasing Kidney Transplantation and Home-Based Dialysis. Nephrology (Carlton), 14, 123-132.

[11]   Domínguez, J., Harrison, R. and Atal, R. (2011) Cost-Benefit Estimation of Cadaveric Kidney Transplantation: The Case of a Developing Country. Transplantation Proceedings, 43, 2300-2304.

[12]   Rocha, M.J., Ferreira, S., Martins, L.S., Almeida, M., Dias, L., Pedroso, S., Henriques, A.C., Almeida, R. and Cabrita, A. (2012) Cost Analysis of Renal Replacement Therapy by Transplant in a System of Bundled Payment of Dialysis. Clinical Transplantation, 26, 529-531.

[13]   Cavallo, M.C., Sepe, V., Conte, F., Abelli, M., Ticozzelli, E., Bottazzi, A. and Geraci, P.M. (2014) Cost-Effectiveness of Kidney Transplantation from DCD in Italy. Transplantation Proceedings, 46, 3289-3296.

[14]   Just, P.M., Riella, M.C., Tschosik, E.A., Noe, L.L., Bhattacharyya, S.K. and de Charro, F. (2008) Economic Evaluations of Dialysis Treatment Modalities. Health Policy, 86, 163-180.

[15]   Karopadi, A.N., Mason, G., Rettore, E. and Ronco, C. (2013) Cost of Peritoneal Dialysis and Haemodialysis across the World. Nephrology Dialysis Transplantation, 28, 2553-2569.