A Review Of Cost Of Illness Studies In Patients With End Stage Renal Disease

End-stage renal disease (ESRD) is a debilitating medical condition of chronic kidney failure. In ESRD, the kidneys are permanently impaired and patients require renal replacement therapy (RRT). In order to understand the economic burden of ESRD, this scoping literature review was undertaken to identify published cost of illness (COI) studies in ESRD. The search strategy identified studies quantifying the economic burden of ESRD in selected countries (USA, Canada, Australia, Japan, UK, France, Germany, Spain, and Italy). We searched electronic databases (MEDLINE, EMBASE, SCIENCE CITATION INDEX, NHSEED, HEED, CEA REGISTRY, RePEc, HTA database) for manuscripts published between January 2003 and November 2013. Results were assessed for relevance by two reviewers. For eligible studies, data extracted included Objectives, costing methodology, sources of data, disaggregated and aggregated costs, and Conclusions. Of 2094 de-duplicated references identified from the combined search, 57 manuscripts remained after review of titles/abstracts and 40 after full-text review. The majority (n=35) of studies used retrospective data; the most common study country was the US (n=16); most studies (n=36) reported direct costs only. There were four national level costing studies. Societal costs for ESRD in Canada totalled $CAN 1.857 billion (2000); cost of RRT in England was £780 million (2009–2010); total public budgetary impact of Spain’s RRT programme was €1,829 million (including indirect costs) in 2010; health costs of ESRD patients with diabetes was $3,611 million in the US and £184.5 million in the UK in 2001. Annual per-patient ESRD health care costs ranged from $US 36,917 (PPP, 2004) in Australia, to $US 96,014 (2002) in US patients with diabetes. Studies also reported national and patient level costs for transplant and dialysis. A number of COI studies have quantified the cost of ESRD and demonstrate the substantial economic burden associated with the management of these patients.