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Original Article

J Korean Soc Transplant 2015; 29(4): 200-208

Published online December 31, 2015

https://doi.org/10.4285/jkstn.2015.29.4.200

© The Korean Society for Transplantation

Quality of Life among End-stage Renal Disease Treatments and Economic Evaluation of Renal Transplantation and Hemodialysis Treatments

Kyung-Ock Jeon, R.N.1, Sun-Young Son, R.N.2, Myung-Il Hahm, Ph.D.3 and Soon-Il Kim, M.D.4

Organ Transplant Center, Severance Hospital, Yonsei University College of Medicine1, Transplant Center, Gangnam Severance Hospital, Yonsei University College of Medicine2, Seoul, Department of Healthcare Management, Soonchunhyang University College of Medical Science3, Asan, Department of Surgery and the Research Institute for Transplantation, Yonsei University College of Medicine4, Seoul, Korea

Correspondence to: Soon-Il Kim
Department of Surgery and the Research Institute for Transplantation, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea
Tel: 82-2-2228-2118, Fax: 82-2-313-8289,
E-mail: soonkim@yuhs.ac
Myung-Il Hahm
Department of Healthcare Management, Soonchunhyang University College of Medical Science, 22 Soonchunhyang-ro, Asan 31538, Korea
Tel: 82-41-530-3035, Fax: 82-41-530-3085
E-mail: hmi@sch.ac.kr

Received: July 28, 2015; Revised: October 2, 2015; Accepted: October 26, 2015

Abstract

Background: Although renal transplantation is known as the best treatment for patients with end-stage renal disease, there are few of literature to identify economic evaluation of renal replacement therapies in Korea. This study was conducted to determine the cost-effectiveness of renal replacement treatments, particularly renal transplantation and hemodialysis.
Methods: We used the quality adjusted life year (QALY) calculated from survey data, which was collected from 124 patients who underwent kidney transplantation and 90 patients who were receiving hemodialysis. Medical costs were collected from five hospitals in Korea. The ERA-EDTA registry data (European Renal Association-European Dialysis and Transplant Association) were used for transition probability. A Markov model was used for predicting the cost-utility of transplantation and hemodialysis over the 10-year period.
Results: Renal transplantation offers lower cost and better outcome compared to hemodialysis. QALY per year of transplantation patients is higher than that of hemodialysis patients (transplantation 0.9465 vs. hemodialysis 0.8297). Cost per QALY gained is 15,566,000 won in transplantation patients whereas 32,765,000 won per QALY gained in hemodialysis patients was required.
Conclusions: Although cost of first year after transplantation was expensive, over 2 years, transplantation was more effective and less costly than hemodialysis. The results suggest that transplantation is more cost-effective than hemodialysis in Korea.

Keywords: Cost-benefit analysis, Kidney transplantation, Hemodialysis, Chronic kidney failure