Economic Evaluation of the Adoption of Peritoneal Dialysis for Newly Diagnosed Hemodialysis Ineligible Pediatric End-Stage Kidney Disease Patients in Egypt
Author(s)
Mohamed Hassany, MD1, Fatina Fadel, MD, Professor2, Ahmed Ibrahim, MSc3, Rascha Galal, MD, Professor2, Islam Anan, MSc4, Irenei Rostom Adly, BVetMED5, Ayman Karkar, PhD6, Omneya Mohamed, PhD6, Mohamed Aladdin, MSc4.
1Ministry of Health and Population, Cairo, Egypt, 2Professor of Pediatric Nephrology, Cairo University, Cairo, Egypt, 3Accsight, Dubai, United Arab Emirates, 4Accsight, Cairo, Egypt, 5Vantive, Middle East and Africa, Cairo, Egypt, 6Baxter Renal Business, Middle East and Africa, Dubai, United Arab Emirates.
1Ministry of Health and Population, Cairo, Egypt, 2Professor of Pediatric Nephrology, Cairo University, Cairo, Egypt, 3Accsight, Dubai, United Arab Emirates, 4Accsight, Cairo, Egypt, 5Vantive, Middle East and Africa, Cairo, Egypt, 6Baxter Renal Business, Middle East and Africa, Dubai, United Arab Emirates.
OBJECTIVES: Pediatric end-stage kidney disease (ESKD) patients aged 14 years and younger, who are ineligible for hemodialysis (HD), face high mortality due to a lack of alternative kidney replacement therapy options in Egypt. This current situation creates significant clinical and economic burdens. In this study, we evaluated the clinical and economic consequences of introducing peritoneal dialysis (PD) as standard care for PD-eligible/HD-ineligible pediatric patients in Egypt.
METHODS: A cost-effectiveness and budget impact analysis was conducted using Excel-based models over 10 and 5-year horizons. The cost-effectiveness analysis applied a Markov model to calculate the difference in quality of life, life-years gained, and overall costs between the current approach and the PD adoption choice for pediatric ESKD patients. The study incorporated global clinical data and local costs, with a 3.5% discount rate. The budget impact model estimated the costs of PD uptake for treating annually newly diagnosed ESKD pediatric patients.
RESULTS: A funnel approach identified 34 annual PD-eligible/HD-ineligible cases from Egypt’s 319 pediatric ESKD incidence. The cost-effectiveness analysis for the eligible cases over a 10-year time horizon showed that PD yielded an extra 1,347 life-years gained compared to the current scenario, with an ICER of $ 587 per life-year, making it cost-effective. Budget impact analysis for 171 cumulative ESKD cases over a 5-year time horizon resulted in a total extra cost of $ 3.2 million, with an average additional cost of $ 8,720 per patient-year compared to the current care in Egypt.
CONCLUSIONS: Adopting PD for pediatric ESKD patients in Egypt would improve clinical outcomes and enhance patient survival compared to current management. The findings of this model would assist decision-makers in efficient resource allocation in pediatric dialysis care in Egypt.
METHODS: A cost-effectiveness and budget impact analysis was conducted using Excel-based models over 10 and 5-year horizons. The cost-effectiveness analysis applied a Markov model to calculate the difference in quality of life, life-years gained, and overall costs between the current approach and the PD adoption choice for pediatric ESKD patients. The study incorporated global clinical data and local costs, with a 3.5% discount rate. The budget impact model estimated the costs of PD uptake for treating annually newly diagnosed ESKD pediatric patients.
RESULTS: A funnel approach identified 34 annual PD-eligible/HD-ineligible cases from Egypt’s 319 pediatric ESKD incidence. The cost-effectiveness analysis for the eligible cases over a 10-year time horizon showed that PD yielded an extra 1,347 life-years gained compared to the current scenario, with an ICER of $ 587 per life-year, making it cost-effective. Budget impact analysis for 171 cumulative ESKD cases over a 5-year time horizon resulted in a total extra cost of $ 3.2 million, with an average additional cost of $ 8,720 per patient-year compared to the current care in Egypt.
CONCLUSIONS: Adopting PD for pediatric ESKD patients in Egypt would improve clinical outcomes and enhance patient survival compared to current management. The findings of this model would assist decision-makers in efficient resource allocation in pediatric dialysis care in Egypt.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE388
Topic
Economic Evaluation
Topic Subcategory
Budget Impact Analysis
Disease
Urinary/Kidney Disorders