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A dynamic Markov model to assess the cost-effectiveness of the Kidney Team at Home intervention in The Netherlands

Author

Listed:
  • Steef Redeker

    (Erasmus Medical Center, Section of Medical Psychology and Psychotherapy, Department of Psychiatry, Postal Address)

  • Sohal Ismail

    (Erasmus Medical Center, Section of Medical Psychology and Psychotherapy, Department of Psychiatry, Postal Address)

  • Hester V. Eeren

    (Erasmus Medical Center, Section of Medical Psychology and Psychotherapy, Department of Psychiatry, Postal Address)

  • Emma K. Massey

    (Erasmus MC, Transplant Institute, Department of Internal Medicine)

  • Willem Weimar

    (Erasmus MC, Transplant Institute, Department of Internal Medicine)

  • Mark Oppe

    (Maths in Health)

  • Jan Busschbach

    (Erasmus Medical Center, Section of Medical Psychology and Psychotherapy, Department of Psychiatry, Postal Address)

Abstract

Objectives The Kidney Team at Home program is an educational intervention aimed at patients with chronic kidney disease to assist them in their choice for kidney replacement therapy. Previous studies have shown that the intervention results in an increase in knowledge and communication on kidney replacement therapy, and eventually in an increase in the number of living donor kidney transplantations. The study assesses the cost-effectiveness of the intervention compared to standard care. Methods A dynamic probabilistic Markov model was used to estimate the monetary and health benefits of the intervention in The Netherlands over 10 years. Data on costs and health-related quality of life were derived from the literature. Transition probabilities, prevalence, and incidence rates were calculated using a large national database. An optimistic and a pessimistic implementation scenario were compared to a base case scenario with standard care. Results In both the optimistic and pessimistic scenario, the intervention is cost-effective and dominant compared to standard care: savings were €108,681,985 and €51,770,060 and the benefits were 1382 and 695 QALYs, respectively. Conclusions The superior cost-effectiveness of the intervention is caused by the superior health effects and the reduction of costs associated with transplantation, and the relatively small incremental costs of the intervention. The favorable findings of this implementation project resulted in national uptake of the intervention in The Netherlands as of 2021. This is the first time a psychosocial intervention has been implemented as part of standard care in a kidney replacement therapy program worldwide.

Suggested Citation

  • Steef Redeker & Sohal Ismail & Hester V. Eeren & Emma K. Massey & Willem Weimar & Mark Oppe & Jan Busschbach, 2022. "A dynamic Markov model to assess the cost-effectiveness of the Kidney Team at Home intervention in The Netherlands," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(4), pages 597-606, June.
    • Handle: RePEc:spr:eujhec:v:23:y:2022:i:4:d:10.1007_s10198-021-01383-0
    DOI: 10.1007/s10198-021-01383-0
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    References listed on IDEAS

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    1. Sigrid M Mohnen & Manon J M van Oosten & Jeanine Los & Martijn J H Leegte & Kitty J Jager & Marc H Hemmelder & Susan J J Logtenberg & Vianda S Stel & Leona Hakkaart-van Roijen & G Ardine de Wit, 2019. "Healthcare costs of patients on different renal replacement modalities – Analysis of Dutch health insurance claims data," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-14, August.
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