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MTPPI Investigates Medicare Costs Associated With AVFs Among US Hemodialysis Patients

MTPPI's latest publication from the research collaboration with Proteon Therapeutics, Rush University Medical Center, and UAB Medicine appears in AJKD

Bethesda, MD – The Medical Technology and Practice Patterns Institute (MTPPI) announces that the results of its research collaboration on the health economics of arteriovenous fistulas with Proteon Therapeutics, Inc., Rush University Medical Center, and the University of Alabama – Birmingham have been published in the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.

The research collaboration was the first initiative in the United States to examine the resources and costs associated with creating and maintaining arteriovenous fistulas (AVFs), which can be critical lifelines for patients on maintenance hemodialysis (HD). National guidelines such as Fistula First, have found that AVFs are the preferred form of vascular access, as patients with AVFs have been observed to have less morbidity and mortality. Despite this, AVFs are limited by high rates of non-maturation, patency loss, and abandonment.

The study team set out to analyze the costs to Medicare of vascular access creation, maintenance, and associated complications using national claims data. The analyses stratified patients into cohorts based on the timing of AVF creation relative to the patient’s HD therapy initiation and evaluated costs over 2.5 years of follow-up based on AVF clinical outcomes.

“Costs in the first year were 4 times as high for patients whose AVFs were not used. Our study, which presents novel data on total vascular access costs within the ESRD program, can be used by clinicians to evaluate their own vascular access protocols and treatment plans.” said Principal Investigator Dr. Mae Thamer. “By focusing on costs due to vascular access–associated hospitalizations from complications in CVCs, AVGs, and AVFs, our study team has been able to quantify the cost impact of CMS’s incentivizing AVFs in Fistula First, Quality Incentive Programs.”

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