Study: End Stage Renal Disease Patients Face Policy Barriers to Home Dialysis

Key Health, Lifestyle Benefits May Elude Growing Patient Community

Mar 03, 2016, 04:00 ET from Alliance for Home Dialysis

WASHINGTON, March 3, 2016 /PRNewswire/ -- Current federal policies limit patient access to home dialysis, a treatment option that offers significant clinical and quality-of-life advantages, according to a report released today by Washington, DC-based economist Alex Brill of Matrix Global Advisors (MGA). As a result of policy barriers, Brill finds, a key segment of the growing population of patients who have End Stage Renal Disease (ESRD) miss out on the important health and lifestyle benefits of home dialysis. Brill, formerly chief economist to the House Ways & Means Committee, also finds that innovation in the home dialysis market may not reach patients if barriers cannot be addressed.

Fewer than 12 percent of patients with ESRD receive home dialysis today, though home dialysis offers patients important health benefits, such as reduced risk of cardiovascular mortality, lower rates of hypertension, and fewer physical health impacts of regular dialysis.  In addition, it offers the ability to be more active and remain in, or re-enter, the workforce. Multiple U.S. studies demonstrate that when educated about the option, 40-50% of patients choose home dialysis. And yet most ESRD patients still travel to a facility multiple times a week to receive dialysis treatments.

According to Brill, the barriers that preclude many patients from accessing home dialysis include the lack of sufficient provider education about home dialysis, insufficient reimbursement for home dialysis, limited patient awareness of the home modality, and potentially burdensome requirements for care partner support. Most of these barriers were also noted in a report by the

U.S.  Government Accountability Office issued fall of 2015.

Brill's study recommends that policymakers alleviate these burdens by focusing on telehealth, reimbursement, patient education, and caregiver issues. He finds that both Congress and federal regulators can do more to help more patients receive the benefits of home dialysis by, among other things:

  • Better reimbursing the cost of home dialysis therapy;
  • Allowing physicians to leverage evolving telehealth and remote monitoring technology for their patients;
  • Funding more patient and physician education on home dialysis options, and
  • Clarifying and simplifying care partner requirements that may confuse patients or otherwise limit home dialysis utilization.

"It is incumbent on policymakers to support policies to achieve greater access to home dialysis," said Brill. "Not only could we see better health outcomes, but with greater uptake, the market can reach a tipping point toward accelerated growth, which can offer incentives for technological innovation that can further benefit patients."

"Home dialysis can offer certain patients tremendous clinical and quality of life benefits," said Dr. Rebecca Schmidt, Chief of the West Virginia University Section of Nephrology and President of the Renal Physicians Association.  "Patients deserve to have choices in their medical care and the option to dialyze at home, when safe and appropriate, is especially key in rural states like mine where many patients live distant to a dialysis center.  Home dialysis allows for    greater independence and our patients have been able to continue or return to work because they feel better and are not tied to an in-center hemodialysis schedule."

"Overcoming policy barriers to home dialysis will allow more patients to gain access to the benefits of home dialysis, including improved survival, better heart health, and increased likelihood for transplantation," said Stephanie Silverman, Executive Director of the Alliance for Home Dialysis. "These are the clinical endpoints all patients hope to achieve."

About the Alliance for Home Dialysis

The Alliance for Home Dialysis is a coalition of kidney dialysis stakeholders—representing patients, clinicians, providers, and industry—that promotes activities and policies that will facilitate treatment choice in dialysis care while identifying and addressing systematic barriers that limit access for patients and their families to the many benefits of home dialysis. The Alliance was launched to continue the work begun at the 2012 National Summit on Home Dialysis Policy, where leaders from the patient, clinician, industry, and academic communities identified a range of concerns that currently hinder, and policy opportunities that can increase appropriate utilization of home dialysis. Visit for more information.

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SOURCE Alliance for Home Dialysis