Objective: To carry out a complete economic evaluation of the cost-effectiveness analysis type of the treatment alternatives for chronic kidney disease in Mexico, from the institutional point of view.

Methodology: A Cost-effectiveness Analysis (ACE) was carried out as the main analysis, and a budget impact analysis as a secondary analysis in 2020. The use of resources was determined for adult patients (18 years or older) with renal failure who are in some type of renal replacement therapy (RRT), be it peritoneal dialysis, hemodialysis or kidney transplantation. The perspective used in the analysis was from the point of the public health sector in Mexico, the time horizon, for the base case was 6 years, and the outcome measures used were life years gained (LYG) and direct medical costs.

Results: In the results of the cost-effectiveness analysis for the base case, RRT has greater efficacy and the lower average cost per patient, with a value of 4.31 LYG and a total cost of $69,585.56 USD, while peritoneal dialysis had 2.87 LYG and a total cost of $77,770.89 USD, and hemodialysis 2.43 AVG and total cost of $103,335.22 USD.

The results of the Budgetary Impact show an average saving of $6,807,055.77 USD by increasing the performance of the TR by 25% in the target population in a period of 5 years.

Conclusions: The complete cost-effectiveness economic evaluation in chronic Renal Insufficiency establishes that for the Mexican population the dominant renal replacement therapy option at 6 years is Renal Transplantation, followed by Peritoneal Dialysis, and finally Hemodialysis. Currently, the practice of transplants in Mexico is scarce and there is still an unmet need for these patients.