Costs and added value of haemodialysis and peritoneal dialysis outsourcing agreements

Background: Despite the discrepancy in results from Spanish studies on the costs of dialysis, it is assumed that peritoneal dialysis (PD) is more efficient than haemodialysis (HD). Objectives: To analyse the costs and added value of HD and PD outsourcing agreements in Galicia, the medical transport for HD and the relationship between the cost of the agreement and the cost of consumables used in continuous ambulatory peritoneal dialysis (CAPD) with bicarbonate. Methods: The cost of the outsourcing agreements and the staff was obtained from official publications. The cost of PD and medical transport were calculated using health service data for one month and extrapolating it to one year. The cost of CAPD consumables was provided by the suppliers. The added value was calculated from the investments generated for each agreement treating 40 patients. Results: Expressed as patient/year, the mean costs for treatment were (sic)21 595 and (sic)25 664 in HD and PD, respectively. Medical transport varied between (sic)3323 and (sic)6338, while those of the CAPD agreement and consumables were (sic)19 268 and (sic)12 057, respectively. The added value was greater with the HD agreement, especially considering the jobs created. Conclusions: One cannot generalise that the cost of PD, which is significantly influenced by prescriptions, is lower than that of HD. It would be appropriate to review the additional cost to consumable; in the CAPD agreement. The added value generated by dialysis agreements should be considered in future studies and in health planning. More controlled studies are needed to better understand this issue.