Monday, July 21, 2008

Does Arogyasree cover PD?

Bill Peckham asked this pertinent question in his Blog Report a couple of days back.

A little history first.

Peritoneal Dialysis (PD) has often been given step motherly treatment by some doctors in India. Hemodialysis is always the treatment of choice for them. Without much reason, I must say. It was never offered as an option to patients. No one ever educated them on the choices available and the advantages and disadvantages of the different modalities.

Your kidneys failed? You need dialysis? Let's get a HD access. It was that simple. I did not even know there was any other modality till about a year after I started hemo.

Only recently has PD been gaining any popularity. I did PD after my transplant failed because I knew about it through the internet and I asked my doctor if I could do PD.

Now, the doctors probably did not discuss PD because of the cost involved. At one point, the cost of PD (Four 2 liter exchanges daily) was roughly twice the cost of HD (thrice a week in-center). For most people the cost of Hemo itself was too much to bear, given the woefully inadequate medical coverage. Most people had to pay their own medical bills. Hemo gave you the ability to live with kidney disease. Why spend more on PD?

Quality of life? What quality of life? You have kidney disease! That you are able to live is a big thing in itself! Stop complaining about quality of life!

Fortunately things are changing. And I think one thing that is contributing to this is the decrease in the average age of the CKD patient. Which of course, is not a good thing. But as an unintended consequence, patients are now asking for options. They want to know what the different treatment modalities available are and many of them have access to information through the internet. So, things like quality of life are being considered important.

Moreover, the cost of PD has now come more within the reach of many people and is not that high compared to Hemo.

Coming back to Bill's question, PD is not covered by Arogyasree. For now, in the realms of kidney disease, only transplants and hemodialysis are included. But as I said before this in itself is a very good start.

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