Cost-effectiveness of dialysis varies
Does it make economic sense to allocate $274,000 per life-year saved for patients with no more than a 10% probability of surviving for six months? No, says a recent study. A team based at Beth Israel Deaconess Medical Center in Boston examined clinical outcomes for nearly 500 seriously ill hospitalized adults with various diagnoses. The study showed that initiating dialysis and continuing aggressive care may not be cost-effective.1
Overall, treatment with dialysis and continued aggressive care is expensive more than $128,000 per quality-adjusted life-year saved. For patients with the best prognosis, defined as a 41% to 60% probability of surviving for six months, the care cost $61,900.
Reference
1. Hamel MB, Phillips RS, Davis RB, et al. Outcomes and cost-effectiveness of initiating dialysis and continuing aggressive care in seriously ill hospitalized adults. Ann Intern Med 1997; 127:195-202.
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