A cost analysis of hemodialysis and peritoneal dialysis for the management of end-stage renal failure at an academic hospital, Pretoria, South Africa

Letlhogonolo Makhele, Moliehi Matlala, Mncengeli Sibanda, Antony P. Martin, Brian Godman

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Background: Hemodialysis (HD) and peritoneal dialysis (PD) are commonly used treatments for the management of patients with end-stage renal disease (ESRD). The costs of managing these patients has grown in recent years with increasing rates of non-communicable diseases, which will adversely impact on national health budgets unless addressed. Currently, there is limited knowledge of the costs of ESRD within the public healthcare system in South Africa. Objective: To examine the direct costs of HD and PD in South Africa from a health care provider's perspective. Methods: A prospective observational study was undertaken at a leading public hospital in South Africa. A micro-costing approach was applied to estimate health care costs using 46 adult patients with ESRD who had been receiving HD and PD for at least 3 months. Results: The highest proportion of patients (35%) were aged 40 to 50 years. Patients aged 29-39 years were mostly on HD () while those between 51-59 years were mostly used PD (). The average age of patients on HD and PD were 41 and 42 years respectively. Variable costs (HD; US$172, 359.15, PD; US$20, 488.79) were found to be the biggest cost drivers for both treatment modalities. The annual cost of HD per patient (US$205,681.4) was higher than PD (US$25,282 per patient) even though the difference was not statistically significant (p = 0.175). Conclusion: HD costs more than PD from the provider’s perspective. These cost estimates may be useful for carrying out future cost-effectiveness and cost-utility analyses in South Africa.
Original languageEnglish
Number of pages19
JournalPharmacoEconomics - Open
Early online date13 Mar 2019
Publication statusE-pub ahead of print - 13 Mar 2019


  • hemodialysis
  • peritoneal dialysis
  • cost analysis
  • renal disease
  • co-morbities
  • South Africa

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