Micro-costing study comparing kidney dialysis modalities in Wales

Our co-director, Professor Rhiannon Tudor Edwards and HCEC research fellow, Dr Ned Hartfiel have co-authored a paper on a micro-costing study comparing four kidney dialysis modalities in Wales. Micro-costing data was obtained from commissioners of the service and from interviews with renal consultants, nurses, accountants, managers and allied health professionals. Top-down costing information was obtained from the Welsh Renal Clinical Network (who commission renal services across Wales) and the Welsh Ambulance Service Trust.

The study found that the annual direct cost per patient for home-based modalities was £16,395 for continuous ambulatory peritoneal dialysis (CAPD), £20,295 for automated peritoneal dialysis (APD) and £23,403 for home-based haemodialysis (HHD). The annual cost per patient for unit-based modalities depended on whether or not patients required ambulance transport.

This study may be the most comprehensive analysis of the costs of dialysis undertaken thus far in the United Kingdom and clearly demonstrate that CAPD is less costly than other dialysis modalities. This detailed analysis of the components that contribute to dialysis costs helps inform future cost-effectiveness studies, inform healthcare policy and drive service redesign.