Economic evaluations of dialysis treatment modalities

Objectives: The purpose of this paper is to review published economic evaluations of dialysis treatment modalities, including hemodialysis (HD) and peritoneal dialysis (PD). Methods: A systematic literature review was conducted in both PubMed and EMBASE for the years 1996-2006. Articles were included if they were original research articles comparing PD and HD or comparing subtypes of PD and HID. Results: Twenty-five articles were included in the formal literature review. The majority of articles were cost evaluations, rather than full economic evaluations of both costs and outcomes. The results show that, in developed nations, HD is generally more expensive than PD to the payer. In developing and emerging economies, mainly due to inexpensive labor and high imported equipment and solution costs, PD is not infrequently perceived to be more expensive than HID. However, the costs of dialysis differ by region and additional research is needed particularly in developing economies. Conclusions: HD is a more expensive dialysis modality in developed regions of the world. Research in the developing world is too limited to draw definitive conclusions. (c) 2007 Elsevier Ireland Ltd. All rights reserved.