Patient, family and productivity costs of endstage renal disease in the Netherlands: exposing non-healthcare related costs

Eline F. de Vries*, J (Jeanine) Los, G. Ardine de Wit, L (Leona) Hakkaart - van Roijen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Healthcare costs related to ESRD are well-described, but broader societal costs of ESRD are less known. This study aimed to estimate patient and family costs, including informal care costs and out-of-pocket costs, and costs due to productivity loss related to ESRD, for patients receiving dialysis and living with a kidney transplant, using a bottom-up approach.

A total of 655 patients were asked to complete a digital questionnaire consisting of two standardised instruments (iMCQ and iPCQ) from November 2016 through January 2017. We applied a retrospective bottom-up cost estimation by combining data from the questionnaire with unit prices from the Dutch costing manual.

Our study sample consisted of 230 patients, of which 165 were kidney transplant recipients and 65 received dialysis. The total annual non-healthcare related costs were estimated at €8284 (SD: €14,266) for transplant recipients and €23,488 (SD: €39,434) for dialysis patients. Costs due to productivity loss contributed most to the total non-healthcare costs (66% for transplant recipients and 65% for dialysis patients), followed by informal care costs (26% resp. 29%) and out-of-pocket costs, such as medication and travel expenses (8% resp. 6%).

By exposing patient, family and productivity costs, our study revealed that dialysis and transplantation are not only costly within the healthcare system, but also incur high non-healthcare costs (18–23% resp. 35% of the total societal costs). It is important to reveal these types of non-healthcare costs in order to understand the full burden of ESRD for society and the potential impact of new therapies.
Original languageEnglish
Article number341
Number of pages9
JournalBMC Nephrology
Issue number1
Publication statusPublished - 16 Oct 2021

Bibliographical note

This work was fnanced by a grant from the Dutch Kidney Foundation.


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