End-stage renal disease (ESRD) is managed by either lifesaving hemodialysis (HD) and peritoneal dialysis (PD) or a kidney\ntransplant. In Malaysia, the prevalence of dialysis-treated ESRD patients has shown an exponential growth from 504 per million\npopulation (pmp) in 2005 to 1155 pmp in 2014. There were 1046 pmp patients on HD and 109 pmp patients on PD in 2014. Kidney\ntransplants are limited due to lack of donors. Malaysia adopts public-private financing model for dialysis. Majority of HD patients\nwere treated in the private sector but almost all PD patients were treated in government facilities. Inequality in access to dialysis is\nvisible within geographical regions wheremajority ofHD centres are scattered around developed areas.Theexpenditure on dialysis\nhas been escalating in recent years but economic evaluations of dialysis modalities are scarce. Evidence shows that health policies\nand reimbursement strategies influence dialysis provision. Increased uptake of PD can produce significant economic benefits and\nimprove patients� access to dialysis. As a result, some countries implemented a PD-First or Favored Policy to expand PD use.Thus,\na current comparative costs analysis of dialysis is strongly recommended to assist decision-makers to establish a more equitable\nand economically sustainable dialysis provision in the future.
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