More Peritoneal Dialysis Use Could Save Medicare Money

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BRIDGEWATER, N.J.—The United States could save more than a billion dollars over five years if 15 percent of all dialysis patients used peritoneal dialysis, according to a study in the April issue of Clinical Therapeutics.

Peritoneal dialysis has been reported to be a less expensive treatment than conventional in-center hemodialysis and could save Medicare money if it is used more. However, PD's use has declined steadily, peaking at 15 percent of all dialysis patients in 1993 and falling to 8 percent in 2005.

To understand PD’s financial impact on future Medicare spending, the researchers performed a five-year budget-impact analysis using data from the 2007 U.S. Renal Data System report.

They found that if PD use decreased to 5 percent over the next five years, Medicare spending on end-stage renal disease patients would increase by approximately $401 million, according to the study. However, if the percentage of PD patients increased to 13 percent over the next five years, then Medicare would save nearly $826 million.

Furthermore, savings would increase to around $960 million if PD use increased to 13 percent over the next four years. And if its use increased to 15 percent by the end of five years, Medicare could see savings equaling more than $1.1 billion, according to the study.

PD is less expensive than in-center HD, which is the most-used form of dialysis. In 2005, Medicare spent $69,758 a year on each HD patient and $50,847 a year on each PD patient, according to the USRDS. Part of the savings, according to the study, is due to lower drug spending, less hospitalizations and the fact that PD patients tend to be younger.

“The magnitude of the potential savings alone provides sufficient justification for further research into the factors that may be impeding greater use of PD (or home dialysis in general) in this country,” the authors wrote.

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