Analytical approach:
A decision analytic Markov model was used to synthesise the data from published studies and national US end-stage renal disease database reports. The authors specified a 20-year period for the analysis and stated that a societal perspective was adopted.
Effectiveness data:
The clinical estimates included patient survival, number of kidney transplants, and incidence of HIV and HCV infections. The evidence for the clinical estimates was abstracted from over 40 published studies and CDC reports, which were produced since 1992, and these were clearly referenced. A few model parameters relating to patients and donors on the waiting list were based on the authors’ estimations.
Monetary benefit and utility valuations:
The utility valuations were obtained from seven published studies and an aggregated utility was used for two health states (HIV and HCV infection) based on the product of the published utility values.
Measure of benefit:
The measure of benefit was quality-adjusted life-years (QALYs), which were discounted at 3% per annum.
Cost data:
The types of resources were the costs of kidney transplants, and HIV and HCV testing. Data on the resources used and their values were derived from the literature except for HIV and HCV testing costs, which were expert opinions. Costs were given in US dollars ($), adjusted to 2002 prices, using the medical component of the consumer price index, and discounted at 3% per annum.
Analysis of uncertainty:
The parameter uncertainty was handled using one- and multi-way sensitivity analyses of the probability, incidence and cost variables. The results were reported in the text and the two-way analyses were presented in a graph.