Economic evaluation of dialysis treatment in end-stage renal disease patients with fluid and sodium overload: Evidence from a randomized controlled trial in Thailand
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Issued Date
2025-11-01
Resource Type
eISSN
19326203
Scopus ID
2-s2.0-105020830405
Pubmed ID
41191592
Journal Title
Plos One
Volume
20
Issue
11 November
Rights Holder(s)
SCOPUS
Bibliographic Citation
Plos One Vol.20 No.11 November (2025)
Suggested Citation
Youngkong S., Yoopetch P., Thavorncharoensap M., Assanatham M., Chaikledkaew U., Sritippayawan S. Economic evaluation of dialysis treatment in end-stage renal disease patients with fluid and sodium overload: Evidence from a randomized controlled trial in Thailand. Plos One Vol.20 No.11 November (2025). doi:10.1371/journal.pone.0335749 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113034
Title
Economic evaluation of dialysis treatment in end-stage renal disease patients with fluid and sodium overload: Evidence from a randomized controlled trial in Thailand
Corresponding Author(s)
Other Contributor(s)
Abstract
Given the lack of cost-effectiveness information, continuous ambulatory peritoneal dialysis (CAPD) with icodextrin (CAPD+ICO) has not yet been included in the Universal Health Coverage (UHC) scheme. This study aimed to evaluate the cost-utility of dialysis treatments for end-stage renal disease (ESRD) patients with fluid and sodium overload, comparing CAPD+ICO and automated peritoneal dialysis (APD) against glucose-based CAPD. A Markov model was applied to evaluate lifetime costs and health outcomes from a societal perspective. Data, including transitional probabilities, direct medical and non-medical costs, and utilities, were collected from randomized controlled trials conducted across 16 hospitals in various regions of Thailand. Compared to glucose-based CAPD, the incremental cost-effectiveness ratio (ICER) for CAPD+ICO was 908,440 THB (26,082 USD) per quality-adjusted life year (QALY) gained, while APD was dominated, incurring higher costs and yielding fewer QALYs. The results indicated that glucose-based CAPD had a 90% probability of being the most cost-effective option from a societal perspective, based on Thailand’s willingness-to-pay (WTP) threshold of 160,000 THB (4,603 USD) per QALY gained. Therefore, CAPD+ICO is not considered a good value for money, requiring an additional annual budget of approximately 58 million THB (2 million USD). These findings provide important economic evaluation evidence to support policy decision-making alongside clinical effectiveness and equity considerations in guiding future UHC benefit package decisions for dialysis modalities among ESRD patients with fluid and sodium overload in Thailand.