Presentation (CTI)

OBJECTIVES: To estimate the budget impact of continuous renal replacement therapy (CRRT) compared with intermittent hemodialysis (IHD) for the management of acute kidney injury (AKI) in Indonesia from a healthcare payer perspective.
METHODS: A budget impact model was developed incorporating an acute hospitalization phase and a chronic dialysis phase. The model population was derived from Indonesian ICU data (952 patients), with AKI incidence of 43%, resulting in 409 patients for analysis. Resource use included dialysis sessions, length of stay, and chronic dialysis utilization. Costs were based on Indonesian National insurance (BPJS) tariffs and government hospital prices. Outcomes included total and per-patient costs, and total budget consequences.
RESULTS: In the acute phase, the cost per patient was lower with CRRT (IDR 2,025,650) vs. IHD (IDR 3,368,124), generating savings of IDR 1,342,475 per patient (39.9%). For the total cohort, acute-phase costs were IDR 829,220,000 for CRRT and IDR 1,378,775,440 for IHD, resulting in total savings of IDR 549,55,440. In the chronic phase, CRRT reduced long-term dialysis dependence (18.9% vs 32.7%), leading to lower annual dialysis costs (IDR 6.42 billion vs IDR 9.08 billion). This translated into annual savings of IDR 2,667,967,007, equivalent to IDR 6,517,410 per patient per year (29.4%).
CONCLUSIONS: CRRT is associated with substantial cost savings compared with IHD in both acute and chronic phases of AKI management in Indonesia. Reduced ICU length of stay and lower long-term dialysis dependence are key drivers of cost savings. Adoption of CRRT may significantly reduce healthcare expenditure for AKI within the Indonesian healthcare system.