Encouraging home dialysis
Dialysis can be a life-sustaining treatment for people with end-stage renal disease (ESRD). It can also be a long and costly treatment. A patient who lands in a clinic dialysis chair may expect to spend as much as five hours per session there, with three sessions each week, for an average of five to 10 years.1 The spend associated with all that treatment time? The average monthly cost is $3,364 for Medicare patients, according to a 2021 report in JAMA Internal Medicine. For non-Medicare patients, the monthly average is more than three times higher, at $10,149.2
With more than half a million Americans now receiving dialysis,3 the total costs are staggering. ESRD patients make up less than 1% (0.1%) of the individual healthcare market, but account for 3.3% of total non-group-plan healthcare spending.4 In other words, the average monthly spending on all services for these patients is 33 times higher than spending for those without ESRD.5
In 2019, the U.S. Department of Health and Human Services launched a program called Advancing American Kidney Health to increase the number of U.S. patients with kidney failure treated at home, whether by peritoneal dialysis or home hemodialysis.6 At that time, Alex M. Azar II, then Secretary of Health and Human Services, called dialysis “one of the most burdensome, draining long-term treatments modern medicine has to offer,” saying it’s “far from sustainable.”7
But there is another option. For patients reluctant to spend hours in a clinic dialysis chair, and for payers looking to bring renal-related care costs under control, at-home dialysis is well worth exploring.