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Med."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to evaluate the cost-effectiveness and financial impact of an anemia management tool (AMT)\u2014a software system that uses real-time blood volume and hemoglobin monitoring data\u2014for adult patients receiving in-center hemodialysis (HD) in the United States. A Markov cohort model was developed to estimate lifetime costs and health outcomes for 1000 in-center HD patients with and without use of AMT. Clinical input parameters, including hemoglobin stability and dose reduction of erythropoiesis-stimulating agents (ESAs), were derived from a randomized controlled trial. The net monetary benefit (NMB) was calculated from the Medicare perspective, while a net financial impact analysis (NFIA) estimated provider-level savings based on ESA dose reductions, Quality Incentive Program (QIP)-related payment adjustments, and implementation costs. From the Medicare perspective, AMT yielded a positive NMB of $8419 per patient over a lifetime and remained cost-effective at a threshold of $2443 per patient per year. The NFIA showed an annual per-patient profit of $218. For a dialysis facility with 70 patients, this corresponds to an annual profit of $15,251. In conclusion, AMT is cost-effective from the Medicare perspective and financially beneficial for providers. Broader adoption may be supported by value-based reimbursement mechanisms and risk-sharing agreements to address residual uncertainties.<\/jats:p>","DOI":"10.1038\/s41746-025-02209-6","type":"journal-article","created":{"date-parts":[[2026,1,3]],"date-time":"2026-01-03T06:37:23Z","timestamp":1767422243000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health-economic evaluation of a novel personalized digital avatar-based anemia management software in hemodialysis patients"],"prefix":"10.1038","volume":"9","author":[{"given":"Afschin","family":"Gandjour","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Kendzia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris H.","family":"Fuertinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Hornig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian","family":"Apel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jovana Petrovic","family":"Vorkapic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,1,3]]},"reference":[{"key":"2209_CR1","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group.","year":"2024","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. 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