Financial Burden of Kidney Disease

Kidney failure comes at a high financial cost for many Canadians

New report shows inequities in financial support for dialysis patients

Canadians living with kidney failure face significant financial challenges as a result of dialysis treatment. Starting dialysis often results in a decrease of income at the same time that out-of-pocket costs increase, such as those for transportation to treatment and medication. Government coverage and financial support for people on dialysis varies, resulting in inequalities across jurisdictions.

The Kidney Foundation and the Canadian Association of Nephrology Social Workers (CANSW) partnered to administer a survey of Canadians on dialysis. The findings are outlined in this report.

The Issue

• Many Canadians report a drop in household income as a result of starting dialysis.
• The proportion of patients on dialysis who are below Canada’s Low Income Cut-Off (LICO) is much higher than the general population.
• Out-of-pocket costs related to dialysis treatment are a significant burden.

Recommendations

Subsidize transportation costs and expand access to travel grants, particularly for people in rural areas.
Minimize disparities in accessing medications for people with kidney disease and develop mechanisms to offset costs equitably across jurisdictions.
Consider the financial and health literacy of patients when operationalizing “home first” policies that aim to maximize the proportion of patients on home dialysis therapies.

Read the Media Release
Read Elizabeth Myles’ editorial

About the Burden of Out-of-Pocket Costs for Canadians with Kidney Failure survey

The Kidney Foundation, in association with Dr. Scott Klarenbach, Professor in the Department of Medicine at the University of Alberta, conducted the Burden of Out-of-Pocket Costs for Canadians with Kidney Failure survey in 2016 to obtain data that would provide evidence of the economic burden associated with dialysis, as well as how this might impact patients and the care they receive. The survey was conducted online and via paper-based surveys administered by CANSW members in over 20 centres and was available in English, French and Chinese.

“As anticipated, we found there are gaps and inconsistencies for people on dialysis across Canada. To help address this, The Kidney Foundation of Canada is calling on governments to act on our recommendations to address the financial burden of kidney failure experienced by Canadians and their families.” - Elizabeth Myles, National Executive Director of the Kidney Foundation.

“As a health economist, I have participated in many studies that consider costs and health outcomes from the health care payer perspective. While this is important to ensure the sustainability of our health care system, much less data and evidence on the financial and economic impact of kidney disease and its treatment from the patient perspective is available. Understanding the financial barriers and consequences might allow policies that lead to optimal health outcomes while minimizing health care costs and the financial burden to patients.” - Dr. Scott Klarenbach, Principal investigator and Professor in the Department of Medicine at the University of Alberta

"The Canadian Association of Nephrology Social Workers was privileged to partner with the Kidney Foundation of Canada in administering the survey of dialysis patients. Our members are passionate about this research and fully endorse the recommended actions. We are all motivated by the hope that the results will help to inform and support advocacy efforts at a national level and help reduce barriers to care and to increase public knowledge of the financial impact of kidney disease." - Michelle Jensen, President of The Canadian Association of Nephrology Social Workers