Modelling the Cost-Effectiveness of Implementing a Dietary Intervention in Renal Transplant Recipients

Friso B. Coerts, Judith J. Gout-Zwart*, Eke G. Gruppen, Yvonne van der Veen, Maarten J. Postma, Stephan J. L. Bakker

*Corresponding author for this work

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Abstract

Background: The Dietary Approach to Stop Hypertension (DASH) and potassium supplementation have been shown to reduce the risk of death with a functioning graft (DWFG) and renal graft failure in renal transplant recipients (RTR). Unfortunately, a key problem for patients is the adherence to these diets. The aim of this study is to evaluate the cost-effectiveness and budget impact of higher adherence to either the DASH or potassium supplementation. Methods: A Markov model was used to simulate the life course of 1000 RTR in the Netherlands. A societal perspective with a lifetime time horizon was used. The potential effect of improvement of dietary adherence was modelled in different scenarios. The primary outcomes are the incremental cost-effectiveness ratio (ICER) and the budget impact. Results: In the base case, improved adherence to the DASH diet saved 27,934,786 and gained 1880 quality-adjusted life years (QALYs). Improved adherence to potassium supplementation saved euro1,217,803 and gained 2901 QALYs. Both resulted in dominant ICERs. The budget impact over a five-year period for the entire Dutch RTR population was euro8,144,693. Conclusion: Improving dietary adherence in RTR is likely to be cost-saving and highly likely to be cost-effective compared to the current standard of care in the Netherlands.

Original languageEnglish
Article number1175
Number of pages17
JournalNutrients
Volume13
Issue number4
DOIs
Publication statusPublished - Apr-2021

Keywords

  • renal transplant recipients
  • kidney failure
  • dietary approaches to stop hypertension
  • diet
  • cost analysis
  • cost effectiveness
  • food technology
  • CORONARY-HEART-DISEASE
  • CHRONIC KIDNEY-DISEASE
  • REPLACEMENT THERAPY
  • ECONOMIC-EVALUATION
  • ADHERENCE
  • QUALITY
  • RISK
  • MORTALITY
  • SURVIVAL
  • GRAFT

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