Skip to main content

Table 5 Results of micro costing calculations*

From: Impact of compliance to oral cysteamine treatment on the costs of Kidney failure in patients with nephropathic cystinosis in the United Kingdom

Stage

Time spent (months) in each stage: unadjusted

Time spent (months) in each stage: adjusted by probability of survival during that stage

Cost

Pre-transplant dialysis†

9.04

8.91

£585.33

First transplant‡

NA

0.98

£835.82

Post first transplant maintenance§

247.40

180.47

£561.41

First failed transplant dialysis†

9.04

4.70

£308.87

 s transplant‡

NA

0.52

£441.04

Post second transplant maintenance§

247.40

95.23

£296.25

 s failed transplant dialysis

NA

111.15

£7,300.93

Total

NA

400.46#

£10,329.65

  1. KF: Kidney Failure, NA; Not Applicable, NHS: National Health service
  2. * The probability of survival per month within the post-KF state was estimated by assuming an exponential distribution of survival probabilities based on the mean time spent in the post-KF state (i.e., 33.37 years; equivalent to ~ 400.46 months). Costs were calculated by considering an average patient’s pathway through the consecutive stages. I.e., first through the “pre-transplant dialysis” (waiting list) phase, and then into their first transplant, and then into the maintenance (time to transplant rejection) phase and so on. The amount of time assigned to each stage was taken from real world data (2nd column) subsequently adjusted by the probabilities of survival during the relevant stage (3rd column), and then multiplied by the relevant cost associated with that phase (4th column)
  3. † The time spent in this stage is based on the time spent on the waiting list for a transplant (Table 4). The unit cost applied here is the monthly cost of dialysis (Table 4), £ 2,192.12
  4. ‡ The value in the 3rd column of this row does not represent the time spent undergoing a transplant (this unspecified time is assumed to be absorbed within the subsequent post, transplant stage). Rather it represents the probability of undergoing a transplant at that time. This probability is applied to the full annual cost of a kidney transplant in the first year (Table 4), £ 28,526.52
  5. § The time spent in this stage is based on the time to transplant rejection or failure (Table 4). It is provided in years (20.62) in Table 4 and converted to months (247.40) here. The unit cost applied here is the subsequent monthly cost of kidney transplant (i.e., maintenance costs), £ 110.93, (Table 4). The unit cost in the first transplant maintenance stage is multiplied by 168.90 months, not 180.47 months, because the cost in the initial 12-month period in this stage (11.57 months accounting for survival probabilities) is accounted for by the annual cost of a transplant. Similarly, the unit cost in the second transplant maintenance stage is multiplied by 89.12 not 95.23 because the cost in the initial 12-month period (6.11 months accounting for survival probabilities) is accounted for by the annual cost of a transplant
  6. ¶ As the average patient undergoes 2 transplants, the time spent in this stage is the remaining time in the post-KF state post rejection/failure of the 2nd transplant. Therefore, there is no “unadjusted” value here - the number of months spent in this stage must be directly calculated
  7. # This sum does not account for the values in the “first transplant”, “second transplant”, or “third transplant” rows as these values represent probabilities rather than time
Back to article page

BMC Nephrology

ISSN: 1471-2369

Contact us