End-Stage Renal Disease and the ''Cost'' of Medical Technology

Richard A. Rettig

ResearchPublished 1977

Reviews developments since Sec. 299I of Public Law 92-603 went into effect, extending Medicare coverage for hemodialysis and renal transplantation for chronic kidney failure. This paper analyzes sources of difficulties surrounding this program, and draws out lessons having potential for other expensive, life-saving technologies. The author reviews the history of hemodialysis and renal transplantation progress, and outlines cost problems of the end-stage renal disease program including lack of accurate cost estimates at inception, failure of the program to transfer many patients to home dialysis, and failure to lower costs by advances in technology. Some lessons drawn from this experience: (1) Efforts to predict dynamics of clinical developments are likely to be wrong in important aspects. (2) R&D is needed on etiology, pathogenesis, and treatment and prevention of disease states for which there is patient treatment benefit program. (3) Policy decisions that allocate scarce resources for saving relatively few lives deserve thoughtful deliberation.

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  • Availability: Available
  • Year: 1977
  • Print Format: Paperback
  • Paperback Pages: 55
  • Paperback Price: $23.00
  • Document Number: P-6029

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RAND Style Manual
Rettig, Richard A., End-Stage Renal Disease and the ''Cost'' of Medical Technology, RAND Corporation, P-6029, 1977. As of October 11, 2024: https://www.rand.org/pubs/papers/P6029.html
Chicago Manual of Style
Rettig, Richard A., End-Stage Renal Disease and the ''Cost'' of Medical Technology. Santa Monica, CA: RAND Corporation, 1977. https://www.rand.org/pubs/papers/P6029.html. Also available in print form.
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