Financial and environmental values for three haemodialysis modalities and their cost-effectiveness
| ICHD | HHD | HNHD | ||||
|---|---|---|---|---|---|---|
| Regime (per week) | 3×4 hours | 3×4 hours | 6×7 hours | |||
| Year | Year 1 | Year 2 | Year 1 | Year 2 | Year 1 | Year 2 |
| Carbon footprint (ton CO2eq, in 2010)a | 4.77b | 3.82 | 4.14b | 3.31 | 9.00b | 7.20 |
| Cost of carbon (£, in 2010)c | 248.17 | 198.54 | 215.02 | 172.02 | 467.81 | 374.24 |
| Cost of treatment (£, 2010)d | 28,131.88 | 27,921.08 | 27,921.08 | 23,412.44 | 35,896.76 | 30,654.04 |
| Quality-adjusted life years (QALY)e | 0.84 | 1.23 | 1.08 | 1.64 | 1.41 | 1.42 |
| Total cost (£, in 2010)f | 28,380.05 | 28,119.62 | 28,136.10 | 23,584.46 | 36,364.57 | 31,028.28 |
| Cost per QALY (£, in 2010) | 33,490.33 | 22,861.48 | 25,852.85 | 14,380.77 | 25,458.70 | 21,850.90 |
| 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