IDEAS home Printed from https://ideas.repec.org/a/spr/aphecp/v23y2025i5d10.1007_s40258-025-00976-7.html
   My bibliography  Save this article

The Cost-Effectiveness of Initiating Patients on Home Dialysis Compared with In-Centre Haemodialysis

Author

Listed:
  • Harry Hill

    (University of Sheffield)

  • James Fotheringham

    (University of Sheffield
    Northern General Hospital)

  • Jessica Potts

    (Keele University)

  • Ivonne Solis-Trapala

    (Keele University)

  • Mark Lambie

    (Keele University)

  • Sarah Damery

    (University of Birmingham)

  • Kerry Allen

    (University of Birmingham)

  • Allan Wailoo

    (University of Sheffield)

  • Iestyn Williams

    (University of Birmingham)

  • Simon Davies

    (Keele University)

Abstract

Objectives Kidney failure can be treated at home with peritoneal dialysis or home haemodialysis. The combination of reduced staffing, transport and overhead costs and improved quality of life through treatment at home could make initiating dialysis at home highly cost-effective. The primary objective is to estimate the cost-effectiveness of initiating patients on home dialysis therapy (HDT) compared with in-centre haemodialysis (ICHD). The secondary objective is to determine the upper limit of net benefit from removing potential service barriers within dialysis centres that hinder the adoption of HDT. Method A multistate model using UK Renal Registry data combined with national survey data was developed to estimate patient and dialysis centre influences on dialysis treatment modality changes and the duration in each modality. These are used as inputs to a microsimulation estimating the lifetime quality-adjusted life years (QALYs) and UK National Health Service (NHS) costs incurred for patients, the cost-effectiveness of HDT compared with ICHD and the differences in costs and health outcomes associated with removing specific barriers to HDT uptake. Results Commencing HDT compared with ICHD resulted in 0.30 additional QALYs and saved Great British (GB) £15,272. HDT has an 82% probability of being cost-effective. Implementing quality-improvement initiatives and alleviating stresses on staff capacity are identified as influential in the multistate model. Addressing these led to QALY gains of 0.22 and 0.08 and cost increases of GB £10,059 and GB £5127 from an increase of life years lived of 0.54 and 0.22, respectively. Conclusions Initiating patients on HDT is cost-effective compared with ICHD. Alleviating stresses on staff capacity and implementing quality improvement initiatives in dialysis centres leads to health improvements, although these changes are not cost-effective owing to the associated increase in healthcare costs.

Suggested Citation

  • Harry Hill & James Fotheringham & Jessica Potts & Ivonne Solis-Trapala & Mark Lambie & Sarah Damery & Kerry Allen & Allan Wailoo & Iestyn Williams & Simon Davies, 2025. "The Cost-Effectiveness of Initiating Patients on Home Dialysis Compared with In-Centre Haemodialysis," Applied Health Economics and Health Policy, Springer, vol. 23(5), pages 919-929, September.
    • Handle: RePEc:spr:aphecp:v:23:y:2025:i:5:d:10.1007_s40258-025-00976-7
    DOI: 10.1007/s40258-025-00976-7
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s40258-025-00976-7
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s40258-025-00976-7?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:spr:aphecp:v:23:y:2025:i:5:d:10.1007_s40258-025-00976-7. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.