Dialysis Costs

13 Jan 2006

Question No:  326  

Question

Name of the Person: Ms Eunice Elizabeth Olsen, Nominated MP

To ask the Minister for Health (a) what is the average effective treatment cost of a dialysis session at public hospitals, private dialysis centres, and VWOs (Voluntary Welfare Organisations); (b) what accounts for the variance in treatment costs; (c) how does Singapore's dialysis costs compare with those of other countries in the region; and (d) what scope is there to further lower dialysis costs at public hospitals and VWOs like NKF.

Reply

Reply From MOH

First, patients can be treated using either haemodialysis (HD) or peritoneal dialysis (PD). PD, in turn, can be provided using either continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD). Each treatment option has its pros and cons, and medical opinion continues to evolve. 

Second, the patients medical conditions will ultimately impact on the treatment option and hence the cost. In particular, those who at the same time have other medical illnesses will have to be handled differently. In some cases, patients with other existing serious illnesses such as stroke may even choose not to be dialysed. 

Third, different providers offer different quality of services, resulting in different costs. For example, there is a range of reagents for the doctors and patients to choose from. Even the same reagent can cost differently, depending on how often the reagent is re-cycled. 

Currently, the treatment cost for HD, without subsidy, ranges from about $2,000 to $3,000 per month. For CAPD, the monthly equivalent is between about $1,200 and $1,800, while that for APD ranges from about $1,700 to $2,300 per month. 

Public hospitals have focused on acute HD with complicated co-existing illnesses. For chronic dialysis, public hospitals offer PD as it is cheaper for the patients. Their CAPD cost, before subsidy, is about $1,300 per month, while the APD equivalent is about $1,800. 

My Ministry will shortly publish on the MOH website, the detailed comparison of the kidney dialysis charges by the various providers in Singapore. Cost comparison with other countries is difficult, because different countries practice different levels of service and care. 

By publishing the dialysis costs, I expect the providers to review their cost structures to see if they can lower their dialysis costs further. 

The new NKF has already made the first round of cost reduction, by reducing its HD rate from $2,600 per month to $2,106. I understand that there is scope for further reduction by the NKF in the near future. Being the largest provider of this service, it really should have the most competitive cost structure and in this way it can stretch its donations to the maximum.