Aston Dialysis Model: The Cost Effectiveness of Home Haemodialysis. By Matthew Campbell Aston Business School: Economics and Strategy Group

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1 Aston Dialysis Model: The Cost Effectiveness of Home Haemodialysis By Matthew Campbell Aston Business School: Economics and Strategy Group

2 Overview of Kimal Kimal is a British, independent and privately owned company founded in 1964 Distributor and manufacturer of medical supplies and equipment sold in over 70 countries world-wide UK Manufacturing and distribution operations are based in Bromsgrove and Droitwich Kimal employs approximately 250 staff and has plans for continued expansion both in the UK and throughout the world. Approx. Turnover = 38M Renal Business = 14%

3 Kidney Disease and Renal Replacement Therapy In England, 4% of the English population aged 18 and over has Chronic Kidney Disease in stages 3-5. NHS Kidney disease: Key facts and figures. Kidney Care p2

4 Treatment Options Transplant Frequent Dialysis Independence Less disruptive Home NxStage System One Portable Lower Carbon Footprint No Installation/ Modifications Required 2-3 weeks patient training Renal Failure Diagnosis H D Dialysis 3 times a week Average distance of Renal Units from Patients Home is 30miles Longer Recovery Time Limited Dialysis Slots Available Hospital Satellite Conventional Dialysis Machines Peritoneal Dialysis Nocturnal Dialysis Permanent Catheter Treatment usually lasts for 4 years APD or CAPD Machines

5 The Problem: 1-2% of the NHS Annual budget is spent on Renal problems yet these patients only make up 0.05% of the population. There is an 8% annual growth rate in the number of renal patients. The Department of Health has set targets to have 15% of dialysis patients at home by 2015 At this moment there is currently just 2.25% of Renal Patients dialysing at home in the UK. Why? The decision making process faced by Health Managers is complex. The cost reductions associated with Home dialysis are not widely recognised.

6 Hypothesis: Home haemodialysis is more cost-effective than In-centre haemodialysis Key research timeline F Valderrabano et al, A Europe wide study investigating management of renal failure for 450,000 patients. Findings: Longer dialysis time leads to significantly less mortality rates. Mowatt et al, A literature review on behalf of NICE. Findings: People on home dialysis have fewer hospital admissions, live longer, are more likely to be in full time work, and have fewer side effects. NHS Centre of Evidence based Purchasing, Home Haemodialysis: a buyers guide. Findings: Home dialysis is more cost effective than hospital and satellite dialysis.

7 Cost Template Specification Identified Significant Cost Areas Critiqued by Advisory Network Research Ethics Approval

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9 Data Collection Challenges Limited NHS Resources Difficult to Locate Apportionment issues Commercial Sensitivity

10 Data Collection Hospital 1 Hospital 2 Hospital 3 Hospital 4 Hospital 5 Year Collected Patients UK Total Patients Percentage ,972 4% , ,850 6% , ,364 6%

11 Data Analysis Data Set Specific Trust Cost Calculator

12 Dialysis Trust A Cost vs Weekly Tariff Comparison between Modality 3 X a week therapy Weekly Cost Weekly Tariff

13 25000 Cost Breakdown Comparison between Modality Overhead Cost Transport Costs Staffing Cost Conversion Cost Equipment Cost Medication Cost Consumable Cost

14 Outcomes of Research Market Insight Cost data for 3,570 patients and 556,920 sessions Literature review has influenced sales strategy on dialysis session frequency Data collection Methodology Kimal s Reputation Medilink Award 1 st place in Innovation audience of 200 Medical Companies, -> entry to National Finals Lord Stafford Award recognition

15 Outcomes of Research Participating Trusts Realise true costs of dialysis in Hospital and Home settings Understand the significance of specific cost areas Feedback to Monitor Future benefits: Benchmark Analysis Justification for more home patients