Dealing with the challenges of End Stage Kidney Disease (ESKD) can be daunting— particularly if one is contemplating treatment overseas.

India has risen as a premier choice for superior yet economical medical services which entices clients globally.

Are you an individual seeking ESKD treatment? Contemplating availing treatment services in India, worried about the cost implications? Look no further than this blog!

Karetrip looks at the charges which come with the treatment of end-stage kidney disease in India, appealing to patients who are preparing to undergo such a treatment. We will take a look at the cost implications of the treatment and also its quality, including why more and more people are opting for India as their preferred choice for end-stage kidney disease treatment. Our aim is to equip you with the necessary details that would enable you make an informed decision on whether or not to seek ESKD treatment in India.

Overview of ESKD Treatment Options

Dialysis: A Lifeline for ESKD Patients:

Types of Dialysis:The treatment for End Stage Kidney Disease (ESKD) primarily involves dialysis which is broadly divided into hemodialysis and peritoneal dialysis.

Hemodialysis is achieved by means of an apparatus that eliminates impurities and surplus liquid from the blood externally with the body; in contrast, peritoneal dialysis takes advantage of the abdomen's membrane to conduct the filtering operation.

Functionality: Both methods aim to filter waste and excess fluid from the body, compensating for the kidneys' diminished capabilities.

Kidney Transplantation: The Path to Recovery:

A Permanent Solution: Unlike dialysis, a kidney transplant offers a cure for kidney failure, involving the surgical placement of a healthy kidney from a donor into the patient's body.

Sources of Kidney Donors: Transplants in India can be performed using kidneys from both living and deceased donors, expanding the possibilities for patients in need.

Accessibility and Prevalence:

• Treatment Reach: Despite the advancement in treatments, only 10-20% of ESRD patients in India continue long-term renal replacement therapy. This highlights the critical need for more accessible treatment options.

• Healthcare Infrastructure: India is equipped with over 820 nephrologists and 710 hemodialysis units, featuring more than 2,500 dialysis stations. Additionally, there are over 172 transplant centers, primarily located in South India and operated by the private sector.

The Challenge of Early Diagnosis:

Regular check-ups are pivotal for the early diagnosis and treatment of kidney disorders, potentially preventing the progression to ESKD. Early detection can significantly improve treatment outcomes and quality of life for those affected.

This overview underscores the importance of dialysis and kidney transplantation as key treatment modalities for ESKD, alongside the necessity for early diagnosis and improved access to care.

Factors Influencing Treatment Cost in India

Economic Burden and Financial Sources

A significant portion of the expenditure for treating Chronic Kidney Disease (CKD) comes from personal savings, accounting for 46% of the total funds.

The major components of out-of-pocket expenditure (OOPE) are medicines and consumables, which constitute 64.1% of these expenses.

Gender and Geographic Disparities

High dropout rates and residual inequities in the care of females with End Stage Kidney Disease (ESKD) necessitate further investigation. Rural areas face challenges in screening and treatment for CKD, often leading to underreporting and unnoticed cases.

Accessibility to dialysis is significantly skewed, with two-thirds of India's population living in rural areas where hemodialysis availability is limited.

Healthcare Infrastructure and Costs

State-funded dialysis programs are increasingly being adopted within universal health care provision in low- and middle-income countries, including India.

Variables affecting the cost of treatment include donor availability, patient condition, type of transplant, and hospital-related factors such as location, classification, and clinical infrastructure.

The cost of treatment varies significantly from one location to another, imposing a considerable financial burden on patients.

Dialysis and Transplantation Costs

The cost of dialysis at specific hospitals can vary based on the type of room or type of treatment chosen by the patient.

The average annual out-of-pocket expenditure per patient with ESRD in India is estimated to be about Rs. 364,488.41, with direct medical costs accounting for 90% of the total direct costs.

The average cost of hemodialysis per patient constitutes about 35% of the total average annual expenditure, with the highest costs incurred by patients who have not undergone transplantation.

International Comparison and Health Expenditure

Health expenditure in India is 4% of the gross domestic product, compared to an average of 10% worldwide, highlighting the limited resources for healthcare and the lack of protection against catastrophic health spending.

The reliance on out-of-pocket health expenditure in India leads to high financial risk and can push patients into catastrophic poverty following an ESRD diagnosis.

Average Cost of Dialysis in India

The financial implications of dialysis treatment in India present a complex picture, influenced by various factors including the type of dialysis, the healthcare setting, and geographical location.

This section delves into the costs associated with hemodialysis (HD) and Continuous Ambulatory Peritoneal Dialysis (CAPD), offering a comprehensive overview to understand the economic burden on patients undergoing dialysis in India.

Hemodialysis Costs:

• Per Session Cost: The cost for a single session of hemodialysis in a public sector tertiary hospital is approximately INR 4148 . However, prices can vary widely, ranging from INR 1,000 to 3,000 per session depending on the facility.

• Monthly Expenditure: For patients undergoing hemodialysis two to three times weekly, the monthly cost ranges from INR 8,000 to 30,000.

• Annual Expenditure: The average annual cost of hemodialysis accounts for 35% of the total average annual expenditure for ESKD patients, with an average monthly cost between ₹24,000 to ₹48,000.

Continuous Ambulatory Peritoneal Dialysis (CAPD) Costs:

Monthly Cost: CAPD, an alternative to hemodialysis, incurs a monthly expense of approximately INR 4000.

Out-of-Pocket Expenditure and Catastrophic Health Expenditure:

• OOPE per Session: The mean OOPE per hemodialysis session is INR 2838 , contributing to the financial strain on patients.

• Prevalence of CHE: Each hemodialysis session has an 11.1% chance of leading to catastrophic health expenditure, underscoring the significant economic impact on patients.

Cost Range and Reimbursement:

• Dialysis Cost Range: The cost of dialysis in India starts from as low as INR Rs.750 to up to INR Rs.5,000 per session.

• Annual Reimbursement Range: The annual reimbursement for hemodialysis in India varies significantly, from approximately 1400 USD to 10,800 USD, illustrating the disparity in coverage.

Additional Costs:

• Erythropoietin Cost: Patients may also incur an additional monthly cost of USD 150-200 for erythropoietin, necessary for managing anemia in dialysis patients.

This detailed exploration of dialysis costs in India highlights the financial challenges faced by patients with ESKD. It underscores the necessity for comprehensive insurance coverage and financial support mechanisms to alleviate the economic burden of dialysis treatment.

Cost and Availability of Kidney Transplantation

Median Costs and Expenditures:

• The median cost for a kidney transplantation procedure in India is estimated at ₹392,920.

• Over a two-year period, patients undergoing dialysis face a significantly higher total median expenditure compared to those who receive a transplant, with costs amounting to ₹500,000 for dialysis patients versus ₹345,000 for transplant recipients.

• Surgery and procedural charges for kidney transplantation average around Rs. 101034.56 ±15048.67.

Cost Variability and Insurance Coverage

• The cost of kidney transplantation in state-run hospitals is mostly free of cost, with monthly immunosuppression costs between INR 2400.

• In private facilities, the procedure can range from INR 5 Lakhs to INR 15 Lakhs or higher, depending on various factors including surgery, hospital stay, and follow-up visits.

• Insurance may cover portions of the costs related to blood and doctor services, though full transplant cost coverage is subject to specific conditions.

Geographic Disparities and Diagnostic Costs:

• The cost for a kidney transplant varies across different cities, with the highest average costs observed in Mumbai, Delhi, and Bangalore.

• Diagnostic tests essential for determining donor and recipient compatibility range from INR 300 to INR 2,00,000.

Market Growth:

• The Indian dialysis market is experiencing rapid growth, with an estimated annual growth rate of 31%.

• This comprehensive overview indicates the financial considerations involved in kidney transplantation in India, highlighting the disparity in costs based on geographic location, healthcare setting, and the integral role of insurance in managing expenses.

The information provided represents the views and opinions of Karetrip. It is crucial to conduct your own independent research before making any decisions regarding your healthcare journey. - Disclaimer