Abstract: TH-PO1186
Cost Utility of High-Dose Online Hemodiafiltration Compared with High-Flux Hemodialysis: Economic Evaluation of the Multinational, Randomized Controlled CONVINCE Trial
Session Information
- Late-Breaking Science Posters
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Authors
- Schouten, Aniek E.M., Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- Fischer, Felix, Charite - Universitatsmedizin Berlin, Berlin, Berlin, Germany
- Blankestijn, Peter J., Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- Vernooij, Robin W.m., Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- Hockham, Carinna, Imperial College London, London, United Kingdom
- Strippoli, Giovanni, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
- Canaud, Bernard J., Montpellier Universite d'Excellence, Montpellier, Occitanie, France
- Hegbrant, Jorgen BA, Lunds Universitet, Lund, Sweden
- Barth, Claudia Maria, B Braun Avitum AG, Melsungen, Hessen, Germany
- Cromm, Krister, Charite - Universitatsmedizin Berlin, Berlin, Berlin, Germany
- Davenport, Andrew, Royal Free Hospital, London, United Kingdom
- Rose, Matthias, Charite - Universitatsmedizin Berlin, Berlin, Berlin, Germany
- Woodward, Mark, Imperial College London, London, United Kingdom
- Bots, Michiel L., Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- de Wit, G. Ardine, Universitair Medisch Centrum Utrecht, Utrecht, Netherlands
- Frederix, Geert, Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
- van der Meulen, Miriam P, Universitair Medisch Centrum Utrecht, Utrecht, Utrecht, Netherlands
Group or Team Name
- The CONVINCE Scientific Committee.
Background
High-flux hemodialysis (HD) and high-dose hemodiafiltration (HDF) are established treatments for patients with kidney failure. HDF has been associated with improved survival rates compared to HD. This study evaluated the cost-effectiveness of HDF compared to HD.
Methods
Cost–utility analyses were performed from a societal perspective alongside the multinational randomized controlled CONVINCE trial, with a two-year and a lifetime time-horizon using a Markov model. Costs of dialysis sessions were based on published data. Other healthcare resource use, productivity losses and quality of life were collected in the eCRF or by country-adapted, self-reported questionnaires. Scenario and probabilistic sensitivity analyses were performed.
Results
HDF was associated with higher utility values compared to HD (0.80 vs 0.78 per year alive), and higher costs (€775 difference per year alive), mainly due to increased dialysis costs (€4/session). Combining these findings with observed mortality in the model resulted in a quality-adjusted life year (QALY) gain of 1.00, with incremental costs per QALY (ICER) ranging from €36,590 to €51,386. The ICER was €15,768 when excluding all costs in additional life years. Sensitivity analyses showed the probability of cost-effectiveness was >75% at willingness-to-pay threshold of €60,000/QALY, and <30% at €20,000/QALY.
Conclusion
Compared to HD, HDF resulted in an additional year in perfect health at increased costs. The probability of cost-effectiveness is mainly driven by dialysis costs in life years gained. At a €60,000/QALY threshold, probability of HDF being cost-effective exceeded 75%. As costs may differ between countries and centers, we recommend translating our results to local settings.
Funding
- Government Support - Non-U.S.