Table 2.
Model Inputs: Costs
| Variable | Baseline Point Estimate | Range or Distribution for Probabilistic Sensitivity Analysis | Source and Notes |
|---|---|---|---|
| Cost of facility-based HD (annual) | $50,075.81 | NA | Ontario Renal Network reimbursement16 |
| Cost of PD (annual) | $39,289.38 (CCPD) $29,969.07 (CAPD) |
NA | Ontario Renal Network reimbursement16 |
| Cost of conventional HHD (annual) | $23,824.69 | NA | Ontario Renal Network reimbursement16 |
| Cost of intensive (nocturnal or short daily) facility-based HD (annual) | $83,467.02 | NA | Ontario Renal Network reimbursement16 |
| Cost of intensive (nocturnal or short daily) HHD (annual) | $36,661.16 | NA | Ontario Renal Network reimbursement16 |
| Cost of transplant procedure | Living donor: $22,628.11 Deceased donor: $26,803.07 |
Living donor: gamma (388.63, 0.017) Deceased donor: gamma (219.67, 0.008) |
Barnieh et al18 |
| Cost of transplant workup | Living donor: $2,667.03 Deceased donor: $3,282.58 |
Living donor: gamma (410.32, 0.154) Deceased donor: gamma (611.10, 0.186) |
Barnieh et al18 |
| Cost of transplant donor-related expenses | Living donor: graft, $20,401.08; workup, $2,544.37; follow-up, $672.95 Deceased donor: graft, $41,624.78; workup, $235.19; follow-up, $0 |
Living donor: graft, gamma (763.73, 0.037); workup, gamma (724.51, 0.285); follow-up, gamma (18.25, 0.027) Deceased donor: graft, gamma (796.05, 0.019)’ workup, gamma (22.56, 0.096); follow-up, NA |
Barnieh et al18 |
| Cost of transplant maintenance treatment (per 30-d cycle) | Living donor: 0-90 d, $11,860.21; 91-360 d, $2,742.30; following years, $1,873.11 Deceased donor: 0-90 d, $10,578.09; 91-360 d, $3,238.82; following years, $2,084.95 |
Living donor: 0-90 d, gamma (62.14, 0.005); 91-360 d, gamma (27.11, 0.010); following years, gamma (29.21, 0.016) Deceased donor: 0-90 d, gamma (148.64, 0.014); 91-360 d, gamma (45.22, 0.014); following years, gamma (35.72, 0.017) |
Barnieh et al18 |
| Cost of PD training | $2,408.84 (CCPD) $2,277.75 (CAPD) |
NA | Ontario Renal Network reimbursement16 |
| Cost of PD retraining | $291.05 (CCPD) $264.83 (CAPD) |
NA | Ontario Renal Network reimbursement16 |
| Cost of HHD training | $11,399.64 | NA | Ontario Renal Network reimbursement16 |
| Cost of HHD equipment installation | $3,000 | NA | Ontario Renal Network reimbursement16 |
| Cost of HHD water testing (annual) | Feed water test: $1,872.97 Product water test: $242.38 Carbon tank exchange (4×/y): $231.08/exchange |
NA | Ontario Renal Network reimbursement16 |
| Cost of HHD retraining (similar for conventional and nocturnal) | $542.84 | NA | Ontario Renal Network reimbursement16 |
| Cost of physician reimbursement (annual; note: physician reimbursement for transplant is included in transplant-related costs) | $6,614 | NA | Ontario Renal Network reimbursement16 |
| Cost of PD catheter placement (assumed to be performed at transition to PD and repeated if off PD modality for ≥3 mo) | $1,069.96 | NA | Ontario Renal Network reimbursement16 |
| Capital cost for dialysis (annual) | Facility-based: $5,475 Home: $3,033 |
NA | Beaudry et al5 |
| Cost of HD access (imaging, surgery, outpatient infections, tPA, and access monitoring) (annual) | $5,751.04 | Surgical costs: inverted log-normal (−7.89, 0.2737) Diagnostic imaging: log-normal (7.46, 0.9536) Outpatient infection costs: log-normal (0, 3.3764) transformed by 1 unit due to median cost of 0 tPA: log-normal (0, 2.3971) transformed by 1 unit due to median cost of 0 Access monitoring: log-normal (0, 3.0549) transformed by 1 unit due to median cost of 0 |
Manns et al17 |
| Cost of infection-related hospital admission | $11,938.53 | Gamma (16, 0.001) | CIHI: CMG 654 other/unspecified sepsis and CADTH HTA report16 |
| Cost of CV disease–related hospital admission | $7,389.67 | Gamma (16, 0.002) | CIHI: mean of CMG 202 (arrhythmia without coronary angiogram) and 175 (PCI with MI/shock/arrest/heart failure) CADTH HTA report16 |
| Cost of other all-cause hospital admission | $8,163.45 × 1.8085 = $14,763.60 | Gamma (16, 0.001) | CIHI: CMG 480 kidney disease, adjusted by comorbidity factor 2 (1.8085) and CADTH HTA report16 |
| Cost of erythropoietin (/mo) | HD: $157.89 HHD: $61.48 PD: $131.81 |
Conventional HD: gamma (16, 0.101) HHD: gamma (16, 0.260) PD: gamma (16, 0.121) |
Manitoba Renal Program Statement of Operations (2016) |
Note: Gamma distributions provided as gamma (α, β); log-normal distributions provided as log-normal (μ, σ). All cost values presented as 2016 Canadian dollars. For inflation calculations using values presented in references, see Item S1.
Abbreviations: CADTH, Canadian Agency for Drugs and Technology in Health; CAPD, continuous ambulatory peritoneal dialysis; CCPD, continuous cycler peritoneal dialysis; CIHI, Canadian Institute of Health Information; CMG, Case Mixed Grouper; CV, cardiovascular; HD, hemodialysis; HHD, home hemodialysis; HTA, Health Technology Assessment; MI, myocardial infarction; NA, not applicable; PCI, percutaneous coronary intervention; PD, peritoneal dialysis; tPA, tissue plasminogen activator.