Soni Meenu Mahak, Mamdouh Heba M, Cochinard Sebastien, Rosselli Diego
Health Economics and Insurance Policies Department, Dubai Health Authority, Dubai, UAE.
Department of Family Health, Alexandria University, Alexandria, Egypt.
Value Health Reg Issues. 2025 Jul;48:101109. doi: 10.1016/j.vhri.2025.101109. Epub 2025 Mar 26.
This study aims to examine the cost-effectiveness of renal transplantation and hemodialysis among patients with end-stage renal disease in Dubai, the United Arab Emirates.
A Markov model was developed to examine the cost-effectiveness of hemodialysis and renal transplant over a 5-year time horizon from the payer perspective, using empirical data on treatment costs from private hospitals in Dubai, utilities from Tufts Cost-Effectiveness Analysis Registry, and transition probabilities from European Renal Association-European Dialysis and Transplant Association registry data.
In the base-case analysis, the discounted average total cost for 5 years was AED 961, 323 ($261 941) for transplantation and AED 971 538 ($264 724) for hemodialysis, with 3.4 and 2.1 quality-adjusted life years (QALY), respectively. The costs of first-year transplant and hemodialysis were AED 470 000 ($128 065) and AED 276 000 ($75 204) with 0.72 and 0.55 QALY, respectively. Transplantation became the dominant treatment strategy by the fourth year and was a cost-effective alternative from the second year on with an incremental cost-effectiveness ratio of AED 53 205 ($14 497 per QALY) (for a cost difference of AED 36 712 ($10 003) and QALY gain of 0.69).
Although the cost of the first year after transplantation was high, transplantation was more effective than hemodialysis over 2 years and was less costly over a longer period. The study suggests that performing renal transplants for patients with end-stage renal disease is more cost-effective than hemodialysis.
