Peritoneal Dialysis Less Costly for Medicare Than Hemodialysis

WEDNESDAY, Aug. 24, 2022 (HealthDay News) -- Peritoneal dialysis (PD) costs Medicare less than hemodialysis, according to a study published online Aug. 18 in the Journal of the American Society of Nephrology.

Jennifer M. Kaplan, M.D., from Baylor College of Medicine in Houston, and colleagues identified Medicare beneficiaries who started dialysis between 2008 and 2015 to determine average annual expenditures (for up to three years after initiation of dialysis) for patients 67 years and older receiving in-center hemodialysis (8,305 patients) or PD (8,305 patients).

The researchers found that overall average expenditures were $108,656 (2017) for hemodialysis and $91,716 for PD (11 percent greater for hemodialysis). This difference persisted over time. Higher estimated intravenous (IV) dialysis drug costs (69 percent higher), rehabilitation expenditures (35 percent higher), and other nondialysis expenditures (34 percent higher) drove higher hemodialysis expenditures. Initial differences in total dialysis expenditures disappeared over time and differences in IV dialysis drug use narrowed, while nondialysis expenditures diverged. There were declines of $2,900 per patient-year for IV drug costs with hemodialysis between 2008 and 2014 versus $900 per patient-year in PD.

"It was reassuring to see that Medicare cost savings from PD persisted over time even as more patients were assigned to this modality," a coauthor said in a statement. "At the same time, a convergence in the use of IV dialysis drugs between the two dialysis modalities suggests that a main economic incentive in favor of PD that was created with expansion of the End-Stage Renal Disease Prospective Payment System in 2011 has diminished over time."

Several authors disclosed financial ties to medical and pharmaceutical companies.

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