Abstract: TH-PO0896
Estimating the Budget Impact of Peritoneal Dialysis Compared with Hemodialysis in the United States
Session Information
- Home Dialysis: Utilization Patterns, Complications, and Quality-of-Life Outcomes
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 802 Dialysis: Home Dialysis and Peritoneal Dialysis
Authors
- Sinha, Araadhna, Symmetron Ltd, London, England, United Kingdom
- Simonic, Eric Adam, Symmetron Ltd, London, England, United Kingdom
- Sharif, Henna, Symmetron Ltd, London, England, United Kingdom
- Rinciog, Claudia I., Symmetron Ltd, London, England, United Kingdom
- Brown, Julie, Vantive US Healthcare LLC, Deerfield, Illinois, United States
- Lassagne, Reginald, Vantive US Healthcare LLC, Deerfield, Illinois, United States
- Hicks, Meagen, Vantive US Healthcare LLC, Deerfield, Illinois, United States
- Danielson, Vanessa, Vantive US Healthcare LLC, Deerfield, Illinois, United States
Background
Kidney failure imposes a substantial global economic burden with direct medical costs projected to rise. Although peritoneal dialysis (PD) is associated with lower annual treatment costs compared with hemodialysis (HD), it remains underutilised amongst incident patients with kidney failure. Recent programmes like the Advancing American Kidney Health Initiative seek to increase use of home dialysis, including PD. Understanding the potential immediate cost savings of improved PD initiation is critical in a disease area with high economic burden. This study aimed to estimate the five-year budget impact of increasing PD uptake to US Medicare spending using a de novo budget impact model (BIM).
Methods
A BIM was developed from the US Medicare perspective to estimate the cost consequences of increasing PD uptake at dialysis initiation by 1.0% per year relative to current practice over a five-year time horizon. The model compares current practice, in which approximately 15% of patients start on PD and 85% start on HD, with an alternative scenario with increased PD uptake. Inputs were identified from the recently published US Renal Data System's annual report, informing the number of prevalent and incident patients with kidney failure per year, current dialysis modality distributions, survival and the cost of each dialysis modality. The model captured total and per-patient costs in the current and alternative scenarios. It also captures the resulting net budget impact to Medicare spending for each cost outcome.
Results
The BIM indicates that increasing PD uptake by 1.0% annually relative to current practice would result in cost-savings over the five-year period between 2026 and 2030. Cost savings were largely driven by lower PD access and medication costs compared to HD. Results remained robust across various scenarios, including alternative PD uptake scenarios.
Conclusion
This model provides a comprehensive, US specific evaluation of the budget impact of PD compared with HD. Increasing PD uptake at dialysis initiation could generate meaningful cost savings in the US in the short- to medium- term. This conclusion is robust to various scenarios, including increasing annual PD uptake. These findings display the benefits of appropriate PD use to mitigate the high cost of kidney failure treatment, supporting recent initiatives to increase PD initiation in the US.
Funding
- Commercial Support – Vantive Ltd