Economic Burden of ESRD to the Malaysian Health Care System

Hirman Ismail, Mohd Rizal Abdul Manaf, Abdul Halim Abdul Gafor, Zaki Morad Mohamad Zaher, Adriana Irawati Nur Ibrahim

Research output: Contribution to journalArticle

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Abstract

Introduction: Prevalence of chronic kidney disease (CKD) in Malaysia is 9.07% of the total population, of which 0.36% are at stage 5 CKD or end-stage renal disease (ESRD). Public-private partnership has improved accessibility of renal replacement therapies (RRT), especially dialysis, in Malaysia, but the economic burden of the existing RRT financing mechanism, which is predominantly provided by the public sector, has never been quantified. Methods: Primary data were collected through a standardized survey, and secondary data analysis was used to derive estimates of the ESRD expenditure. Results: Total annual expenditure of ESRD by the public sector has grown 94% within a span of 7 years, from Malaysian Ringgit [MYR] 572 million (US dollars [USD] 405 million, purchasing power parity [PPP] 2010) in 2010 to MYR 1.12 billion (USD 785 million, PPP 2016) in 2016. The total ESRD expenditure in 2010 constituted 2.95% of the public sector's total health expenditure, whereas in 2016, the proportion has increased to 4.2%. Only 6% of ESRD expenditure was spent on renal transplantation, and the remaining 94% was spent on dialysis. Conclusion: The share of ESRD expenditure in total health expenditure for the public sector is considered substantial given only a small proportion of the population is affected by the disease. The rapid increase in expenditure relative to the national total health expenditure should warrant the relevant authorities about sustainability of the existing financing mechanism of ESRD and the importance to institutionalize more drastic preventive measures.

Original languageEnglish
Pages (from-to)1261-1270
Number of pages10
JournalKidney International Reports
Volume4
Issue number9
DOIs
Publication statusPublished - 1 Sep 2019

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Health Expenditures
Chronic Kidney Failure
Economics
Delivery of Health Care
Public Sector
Renal Replacement Therapy
Malaysia
Parity
Chronic Renal Insufficiency
Dialysis
Public-Private Sector Partnerships
Kidney Transplantation
Population

Keywords

  • chronic kidney disease
  • dialysis
  • end-stage renal disease
  • microeconomics
  • national health expenditure
  • renal transplantation

ASJC Scopus subject areas

  • Nephrology

Cite this

Economic Burden of ESRD to the Malaysian Health Care System. / Ismail, Hirman; Abdul Manaf, Mohd Rizal; Abdul Gafor, Abdul Halim; Mohamad Zaher, Zaki Morad; Ibrahim, Adriana Irawati Nur.

In: Kidney International Reports, Vol. 4, No. 9, 01.09.2019, p. 1261-1270.

Research output: Contribution to journalArticle

Ismail, Hirman ; Abdul Manaf, Mohd Rizal ; Abdul Gafor, Abdul Halim ; Mohamad Zaher, Zaki Morad ; Ibrahim, Adriana Irawati Nur. / Economic Burden of ESRD to the Malaysian Health Care System. In: Kidney International Reports. 2019 ; Vol. 4, No. 9. pp. 1261-1270.
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abstract = "Introduction: Prevalence of chronic kidney disease (CKD) in Malaysia is 9.07{\%} of the total population, of which 0.36{\%} are at stage 5 CKD or end-stage renal disease (ESRD). Public-private partnership has improved accessibility of renal replacement therapies (RRT), especially dialysis, in Malaysia, but the economic burden of the existing RRT financing mechanism, which is predominantly provided by the public sector, has never been quantified. Methods: Primary data were collected through a standardized survey, and secondary data analysis was used to derive estimates of the ESRD expenditure. Results: Total annual expenditure of ESRD by the public sector has grown 94{\%} within a span of 7 years, from Malaysian Ringgit [MYR] 572 million (US dollars [USD] 405 million, purchasing power parity [PPP] 2010) in 2010 to MYR 1.12 billion (USD 785 million, PPP 2016) in 2016. The total ESRD expenditure in 2010 constituted 2.95{\%} of the public sector's total health expenditure, whereas in 2016, the proportion has increased to 4.2{\%}. Only 6{\%} of ESRD expenditure was spent on renal transplantation, and the remaining 94{\%} was spent on dialysis. Conclusion: The share of ESRD expenditure in total health expenditure for the public sector is considered substantial given only a small proportion of the population is affected by the disease. The rapid increase in expenditure relative to the national total health expenditure should warrant the relevant authorities about sustainability of the existing financing mechanism of ESRD and the importance to institutionalize more drastic preventive measures.",
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N2 - Introduction: Prevalence of chronic kidney disease (CKD) in Malaysia is 9.07% of the total population, of which 0.36% are at stage 5 CKD or end-stage renal disease (ESRD). Public-private partnership has improved accessibility of renal replacement therapies (RRT), especially dialysis, in Malaysia, but the economic burden of the existing RRT financing mechanism, which is predominantly provided by the public sector, has never been quantified. Methods: Primary data were collected through a standardized survey, and secondary data analysis was used to derive estimates of the ESRD expenditure. Results: Total annual expenditure of ESRD by the public sector has grown 94% within a span of 7 years, from Malaysian Ringgit [MYR] 572 million (US dollars [USD] 405 million, purchasing power parity [PPP] 2010) in 2010 to MYR 1.12 billion (USD 785 million, PPP 2016) in 2016. The total ESRD expenditure in 2010 constituted 2.95% of the public sector's total health expenditure, whereas in 2016, the proportion has increased to 4.2%. Only 6% of ESRD expenditure was spent on renal transplantation, and the remaining 94% was spent on dialysis. Conclusion: The share of ESRD expenditure in total health expenditure for the public sector is considered substantial given only a small proportion of the population is affected by the disease. The rapid increase in expenditure relative to the national total health expenditure should warrant the relevant authorities about sustainability of the existing financing mechanism of ESRD and the importance to institutionalize more drastic preventive measures.

AB - Introduction: Prevalence of chronic kidney disease (CKD) in Malaysia is 9.07% of the total population, of which 0.36% are at stage 5 CKD or end-stage renal disease (ESRD). Public-private partnership has improved accessibility of renal replacement therapies (RRT), especially dialysis, in Malaysia, but the economic burden of the existing RRT financing mechanism, which is predominantly provided by the public sector, has never been quantified. Methods: Primary data were collected through a standardized survey, and secondary data analysis was used to derive estimates of the ESRD expenditure. Results: Total annual expenditure of ESRD by the public sector has grown 94% within a span of 7 years, from Malaysian Ringgit [MYR] 572 million (US dollars [USD] 405 million, purchasing power parity [PPP] 2010) in 2010 to MYR 1.12 billion (USD 785 million, PPP 2016) in 2016. The total ESRD expenditure in 2010 constituted 2.95% of the public sector's total health expenditure, whereas in 2016, the proportion has increased to 4.2%. Only 6% of ESRD expenditure was spent on renal transplantation, and the remaining 94% was spent on dialysis. Conclusion: The share of ESRD expenditure in total health expenditure for the public sector is considered substantial given only a small proportion of the population is affected by the disease. The rapid increase in expenditure relative to the national total health expenditure should warrant the relevant authorities about sustainability of the existing financing mechanism of ESRD and the importance to institutionalize more drastic preventive measures.

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