Incremental cost-effectiveness analysis of a multidisciplinary renal education program for patients with chronic renal disease.

Abstract

The aim of this economic evaluation is to address the economic impact of a multidisciplinary renal patient education on the work maintenance of patients with chronic renal disease. A total of 281 patients were recruited. An incremental cost-effectiveness analysis considering direct medical costs and days in the work force was performed. In addition, a Cox proportional hazards survival analysis was performed to investigate the effect of receiving the intervention on early retirement due to work disability. The incremental cost-effectiveness ratio [95% CI] per day in the work force saved was 737.02 degrees euro [-3345.64; 3093.03] in the whole group, 73.74 degrees euro [-995.28; 1429.92] in patients with a mild limitation and -113.25 degrees euro [-3252.06; 1525.58] in patients with a moderate to severe limitation in kidney function. After adjusting for observed time period, serum creatinine and age, having received the intervention had an almost significant medium-term protective effect on early retirement (hazard ratio 0.314, 95% CI 0.10-1.03, p = 0.0557). The cost-effectiveness of the multidisciplinary patient education highly depends on the level of limitation in kidney function and the intervention may be cost-effective in maintaining patients with mild limitation in kidney function in the work force.