Objectives: Patients with end-stage renal disease (ESRD) require dialysis or transplantation to maintain patients’ lives. Hemodialysis (HD) and Peritoneal Dialysis (PD) are two major treatment modalities. The use of HD is more prevalent than PD in many countries. This study aimed to assess the cost-effectiveness of hemodialysis vs. peritoneal dialysis in patients with ESRD from the payers’ perspective.

Methodology: A Markov Model was built to predicts the transitional between ESRD and death using data from existing literature. The cost for ESRD and death were from previously published data. Quality-adjusted-life-years (QALYs) for ESRD and death were estimated using data from existing literature. The simulation was conducted over 14 years, with both QALY and cost discounted at an annual rate of 3%. Incremental Net Benefit (INB) for (PD vs. HD) was calculated based on a Willingness to Pay (WTP) of $ 50,000/QALY.

Results: Mortality rate was higher in patients receiving HD (94%) than patients receiving PD (89%). From the perspective of payers’, the total cost was lower among the patients receiving PD ($858,443) as compared to patients receiving HD ($1,082,730). Upon calculating QALY, PD provided better effectiveness (5.46 QALYs) than HD (4.66 QALYs). After calculating the INB ($264,701), PD was found to be cost-effective as compared to HD at WTP $50,000. Sensitivity analysis (using 20% range) showed PD was more cost-effective at WTP $60,000 and $40,000, however, the results were insensitive to the INB.

Conclusion: Based on the values for total cost and QALY, it was observed that PD was found to be more cost saving compared to HD. Evidence provided in this study could help policymakers with regard to prioritizing dialysis modalities.