Table 1.

Financial and environmental values for three haemodialysis modalities and their cost-effectiveness

Regime (per week)3×4 hours3×4 hours6×7 hours
YearYear 1Year 2Year 1Year 2Year 1Year 2
Carbon footprint (ton CO2eq, in 2010)a4.77b3.824.14b3.319.00b7.20
Cost of carbon (£, in 2010)c248.17198.54215.02172.02467.81374.24
Cost of treatment (£, 2010)d28,131.8827,921.0827,921.0823,412.4435,896.7630,654.04
Quality-adjusted life years (QALY)e0.841.231.081.641.411.42
Total cost (£, in 2010)f28,380.0528,119.6228,136.1023,584.4636,364.5731,028.28
Cost per QALY (£, in 2010)33,490.3322,861.4825,852.8514,380.7725,458.7021,850.90
ICERg –£1,016.46–£11,061.37£14,007.92£15,308.78
  • aConnor et al (2010)18

  • bFirst year initiation emissions were not available. A 25% uplift is added to yearly emission rates in the first year to account for this.

  • cnon-traded carbon price of £52 per ton CO2eq, DECC (2009)20

  • dKomenda et al (2012)19

  • eQALYs for ICHD and HHD from Beby et al (2016)21. QALYs for HNHD from Klarenbach et al (2014)22

  • fTotal cost is the sum of the cost of carbon and the financial cost of treatment

  • gwith reference to ICHD

  • HHD = haemodialysis; HNHD = home nocturnal haemodialysis; ICHD = in-centre haemodialysis; QALY = quality-adjusted life years