OBJECTIVES: The prevalence of patients who undergo renal replacement therapy (RRT) in Moscow was steadily growing during the last decade. Given study assesses the economic impact of the increase in the number of kidney transplantations in these patients in Moscow, Russia.

METHODS: Hemodialysis (HD) and kidney transplantation (KT) are dominant modalities of RRT in Russia, so only these two options were considered. The study compared two strategies: 1) patients on waiting list for KT receive transplantation with current rate observed in Moscow and 2) patient eligible for KT receive transplantation with the faster rate. Cost-effectiveness analysis was conducted using a Markov model with three health states: patient on HD, patient with KT, death. Modeled population represented Moscow patients with kidney failure starting HD therapy. Effectiveness measures were life years (LY) and QALYs. Costs included direct medical costs (costs for transplantation procedure, hemodialysis, managing transplant failure, creating an access to the circulatory system for HD, drugs and specialists consultations) and direct non-medical costs (transportation costs). Both outcomes and costs were discounted at 5 % rate. Deterministic sensitivity analysis was performed.

RESULTS: The study found the second strategy to be dominant. In the base case scenario during 10 years expenses for treating of one average patient in the first strategy was 172,844 USD and 164,304 USD in the second one (costs converted to USD using official exchange rate on 27.06.2020: 69.1284 RUR/USD). Meanwhile second strategy was more efficient: one average patient during 10 years accumulated 3.269 QALY and 5.164 LY, 3.001 QALY and 4.935 LY in the first strategy. Sensitivity analysis confirmed the robustness of the results.

CONCLUSIONS: The results of the study show the necessity to increase the number of transplantations in patients with kidney failure, as it is associated with better clinical outcomes and cost savings within Moscow healthcare conditions.