OBJECTIVES:

To determine costs of Continuous Ambulatory Peritoneal Dialysis (CAPD) and Hemodialysis (HD) treatment, as well as to determine cost-effectiveness between CAPD and HD modality in treating patients with Chronic Kidney Disease in Indonesia.

METHODS:

Patients with End-Stage Renal Diseases, aged >50 undergoing each modalities, CAPD and HD, were observed retrospectively. Clinical records were taken during the observation, as well as questionnaire used to gather cost description during CAPD and HD treatment. Costs’ were calculated and utility was measured using Quality-Adjusted Life Years (QALYs), using Markov as analytic decision model. In the end of analysis, Incremental Cost-Effectiveness Ratio (ICER) was calculated using costs and QALYs of each modality, as well as probability sensitivity analysis.

RESULTS:

Using societal perspective, it can be concluded from ICER calculation, CAPD may save IDR 48,850,332 per QALY gained, compared with HD. From the sensitivity analysis, CAPD can be categorized cost-effective when the calculation was plotted in the cost-effectiveness plane. Using five projections in five different parameter scenarios, it is concluded that as the transition of probability to CAPD increases, CAPD will still be cost-saving compared to HD.

CONCLUSIONS:

Although the average direct medical costs of CAPD is higher than HD, in terms of cost-effectiveness, the results suggest that offering PD as an initial treatment for chronic kidney disease patients would be a better choice than offering HD in the long run.