Is online hemodiafiltration a cost-effective alternative to conventional hemodialysis?

In this issue, Schouten et al. report findings from a cost-effectiveness analysis of hemodiafiltration versus conventional high-flux hemodialysis using data from the Comparison of High-Dose Hemodiafiltration with High-Flux Hemodialysis (CONVINCE) trial. They found that the overall cost-effectiveness of hemodiafiltration is within the range of accepted willingness-to-pay thresholds in some countries, while near (but outside) the lower-bound thresholds of other countries. How decision-makers value treatment costs for additional years on dialysis and country-specific costs and willingness-to-pay thresholds influence the cost-effectiveness of hemodiafiltration.