COST OF ILLNESS AND ITS IMPACT ON QUALITY OF LIFE OF PATIENTS ON MAINTENANCE HEMODIALYSIS

Priya Satheesh, P. Thennarasu*, N. Vanitha Rani and P. Soundararajan

ABSTRACT

In India, majority of patients with End stage renal disease (ESRD) can afford only hemodialysis and the cost of maintenance hemodialysis (MHD) differs across the country. A study was conducted in 108 patients aged 18years or older, on MHD to assess the cost of illness and its impact on quality of life of patients on MHD. The medical costs were collected from various units of the hospital and the prescription was analyzed to assess the cost factor involved in the medications. Non- medical costs and indirect costs were collected from the patients directly. The Quality of Life (QOL) was assessed using Short form 36 questionnaire. The data collected was analyzed with SPSS 17.0 version. Paired t-test was used to find the significant difference and Pearson's correlation was used to assess the relationship between the variables. A probability value of P ≤ 0.05 was considered as statistically significant. The average cost per session was found to be Indian Rupee (INR) 1500, this included the dialysis session cost only excluding all other costs. The mean total annual cost of dialysis per patient was estimated to be INR 5, 42,299. The cost factor for direct medical expense amounted to INR 52,420 per month, direct non-medical cost amounted to INR 6,856 per month and the indirect cost amounted to INR 6,759 per month. Apart from this monthly cost, there were additional expenses in direct medical cost which included ICU admissions costs for major complications, hospitalization costs for access procedures and for other complications. Erythropoietin contributed to 81% of the total drug cost spent by MHD patients. The physical component showed a higher score compared to the mental component of health related QOL. There was a significant correlation between cost of illness and physical/mental components of health related QOL. This study identified that direct costs were momentous when compared to indirect costs. This information can form a basis for further pharmacoeconomic studies.

Keywords: End stage renal disease, chronic kidney disease, maintenance hemodialysis, renal replacement therapy, quality of life.