A new study provides insights into the cost of peritoneal dialysis versus haemodialysis across the world including Singapore
While peritoneal dialysis (PD) has a number of advantages, including the possibility of it being offered in remote locations, it remains an underused modality in most parts of the world. Here we report results from a global analysis demonstrating that PD offers improved or at least similar cost-effectiveness to haemodialysis (HD) in the majority of countries.1
Karopadi and colleagues performed a literature search that yielded 78 relevant articles, allowing the cost of PD versus HD to be calculated for 46 countries (20 developed and 26 developing). As shown in Figure 1, results demonstrated that the cost of HD was:1
- 1.25–2.35 times the cost of PD in 22 countries (17 developed and 5 developing)
- 0.90–1.25 times the cost of PD in 15 countries (2 developed and 13 developing)
- 0.22–0.90 times the cost of PD in 9 countries (1 developed and 8 developing)
Figure 1. Map summarising the HD/PD cost ratios in 51 countries (survey data included).1
Note: The darker the colour, the greater the cost effectiveness of PD.
In Singapore, the HD/PD ratio supported PD as a more cost-effective option than HD, with a value of 1.38. The government of Singapore offers the same reimbursement for both modalities with PD accounting for 19% of dialysis treatments.1
The authors concluded that PD is a more cost-effective option for healthcare systems in the majority of developed countries. Results for developing countries were more variable, but in most cases PD can at least be provided at a similar cost to HD, particularly in cases where economies of scale have been achieved (either by local production or by low import duties on PD equipment).1
- Karopadi AN, Mason G, Rettore E, Ronco C. Cost of peritoneal dialysis and haemodialysis across the world. Nephrology Dial Transplant. 2013 Oct;28(10):2553-69.