A recent study by Bangladesh Institute of Development Studies (BIDS) on the cost and burden of kidney dialysis has revealed a grim picture. Conducted on 477 patients across public, private, and NGO-run hospitals, the study has found that 93 percent of families experienced financial distress in accessing kidney dialysis—the primary treatment option for end-stage kidney failure (ESKF) patients.

In a country where an estimated 200-250 people per million develop ESKF each year and require dialysis, the average monthly treatment cost of Tk 46,426 is too high considering that our average monthly household income, according to an official estimate from 2022, is just Tk 32,422. As per the BIDS study, 19.5 percent of the surveyed kidney patients received fewer dialysis sessions than medically recommended because of the high cost, jeopardising their health further.

Bangladesh is already struggling with a high rate of out-of-pocket health expenditure. The exorbitant cost of kidney dialysis adds another layer to the challenges of our health system that often pushes people below the poverty line instead of safeguarding their right to health. While wealthier patients face higher absolute costs, poorer patients bear a disproportionately heavier financial burden. Unfortunately, the alternative treatment option—a kidney transplant—is often unattainable for the poor due to its high one-time cost and the risk of exploitation by unscrupulous donors.

Another interesting finding of the study is that most patients prefer NGO-run treatment centres to public and private ones, even though public hospitals offer the lowest dialysis costs. This raises questions about the quality and trustworthiness of our public health infrastructure. While reform is required in our overall health system, the issue of high kidney dialysis costs can be addressed in the short term by following the recommendations made in the research report.

The recommendations include subsidising the costs at private hospitals, expanding access to treatment by establishing facilities in semi-urban and rural areas, encouraging local pharmaceutical production of kidney disease drugs to lower prices, and incorporating low- and middle-income patients into the government's social safety net programmes. However, the long-term goal should be to reduce the disparity in our health sector by regulating fees and treatment costs across the public and private health facilities.