Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0177436
Title: Economic evaluation of policy options for dialysis in end-stage renal disease patients under the universal health coverage in Indonesia
Authors: Afiatin
Khoe L.C.
Kristin E.
Masytoh L.S.
Herlinawaty E.
Werayingyong P.
Nadjib M.
Sastroasmoro S.
Teerawattananon Y. 
Keywords: adult
Article
budget
cost benefit analysis
cost effectiveness analysis
economic evaluation
end stage renal disease
health care access
health care policy
health insurance
hemodialysis
human
Indonesia
major clinical study
peritoneal dialysis
quality adjusted life year
treatment planning
economics
health care policy
hemodialysis
insurance
Kidney Failure, Chronic
Markov chain
Cost-Benefit Analysis
Health Policy
Humans
Indonesia
Kidney Failure, Chronic
Markov Chains
Renal Dialysis
Universal Coverage
Issue Date: 2017
Publisher: Public Library of Science
Citation: Afiatin, Khoe L.C., Kristin E., Masytoh L.S., Herlinawaty E., Werayingyong P., Nadjib M., Sastroasmoro S., Teerawattananon Y. (2017). Economic evaluation of policy options for dialysis in end-stage renal disease patients under the universal health coverage in Indonesia. PLoS ONE 12 (5) : e0177436. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0177436
Abstract: Objectives: This study aims to assess the value for money and budget impact of offering hemodialysis (HD) as a first-line treatment, or the HD-first policy, and the peritoneal dialysis (PD) first policy compared to a supportive care option in patients with end-stage renal disease (ESRD) in Indonesia. Methods: A Markov model-based economic evaluation was performed using local and international data to quantify the potential costs and health-related outcomes in terms of life years (LYs) and quality-adjusted life years (QALYs). Three policy options were compared, i.e., the PD-first policy, HD-first policy, and supportive care. Results: The PD-first policy for ESRD patients resulted in 5.93 life years, equal to the HD-first policy, with a slightly higher QALY gained (4.40 vs 4.34). The total lifetime cost for a patient under the PD-first policy is around 700 million IDR, which is lower than the cost under the HD-first policy, i.e. 735 million IDR per patient. Compared to supportive care, the incremental cost-effectiveness ratio of the PD-first policy is 193 million IDR per QALY, while the HD-first policy resulted in 207 million IDR per QALY. Budget impact analysis indicated that the required budget for the PD-first policy is 43 trillion IDR for 53% coverage and 75 trillion IDR for 100% coverage in five years, which is less than the HD-first policy, i.e. 88 trillion IDR and 166 trillion IDR. Conclusions: The PD-first policy was found to be more cost-effective compared to the HD-first policy. Budget impact analysis provided evidence on the enormous financial burden for the country if the current practice, where HD dominates PD, continues for the next five years. © 2017 Afiatin 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.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/166008
ISSN: 19326203
DOI: 10.1371/journal.pone.0177436
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