HTA Assessment of Clinical-care Pathways: Peritoneal Dialysis Vs Hemodialysis - Content Summary

Peritoneal dialysis (PD) is used in Italy for less than 10% of patients on dialysis, with considerable inter-regional variability. The ALTEMS research using HTA methodology set out to assess whether this is justified on economic grounds. Effectiveness measured in terms of Quality Adjusted Life Years (QALY) is 1.20 for PD compared to the 0.94 of hospital hemodialysis (HD). In terms of cost-utility analysis, PD is therefore “dominant” as it is more effective and less costly, and as a result is the treatment of choice from both clinical and economic points of view, as well as from both social and SSN perspectives. On Budget Impact Analysis (BIA), the real annual cost per patient from the social perspective is € 24,142 for PD and € 42,231 for HD. A hypothetical greater use of PD, with an annual increase of at least 5% of patients on PD, would result in savings over a 5-year period of close to 100 million euro.