Medicare expenditures could be reduced by increased peritoneal dialysis use
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Between 2008 and 2015, overall average Medicare expenditures were 11% more for in-center hemodialysis than home-based peritoneal dialysis.
“National policy reforms are focusing on promoting the use of PD. These are in part due to the expectation that peritoneal dialysis is less costly than in-center hemodialysis,” Kevin F. Erikson, MD, MS, associate professor of medicine at Baylor College of Medicine, told Healio. “We examined Medicare expenditures in similar patients starting these two dialysis modalities in order to see if peritoneal dialysis is actually less costly for Medicare. We also examined whether differences in cost have persisted over time as more patients are being put on PD.”
In a retrospective analysis, researchers evaluated Medicare beneficiaries aged at least 67 years who started in-center hemodialysis or PD between 2008 and 2015.
Specifically, researchers measured annual expenditures for up to 3 years after dialysis initiation to find if differences in Medicare costs across dialysis modalities persisted as more patients began PD.
Using propensity scores, researchers matched 8,305 patients initiating PD with 8,305 patients starting hemodialysis.
Researchers identified a total of $108,656 spent for hemodialysis and $91,716 for PD, a cost difference that did not significantly differ over time. Analyses revealed hemodialysis had 69% higher estimated intravenous dialysis drug costs, 35% higher estimated rehabilitation expenditures and 34% higher estimated other nondialysis expenditures, resulting in 11% higher costs than home-based PD. Additionally, the estimated intravenous drug costs decreased by $2,900 per patient-year in hemodialysis from 2008 to 2014 vs. $900 per patient-year in PD.
“Our findings are important because they suggest that Medicare expenditures could, in fact, be reduced by a shift towards more use of PD,” Erikson told Healio. “This study was informative but also raised several questions. We are currently conducting additional investigations into cost differences between these two dialysis modalities.”
Reference:
- Peritoneal dialysis costs Medicare less than hemodialysis, even as more patients are placed on peritoneal dialysis. https://www.eurekalert.org/news-releases/962044. Published Aug. 18, 2022. Accessed Aug. 19, 2022.
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