TY - JOUR
T1 - Payment for Living Donor (Vendor) Kidneys
T2 - A Cost-Effectiveness Analysis
AU - Matas, Arthur J.
AU - Schnitzler, Mark
PY - 2004/2
Y1 - 2004/2
N2 - The supply of kidneys does not meet the demand. As a consequence, the waiting time for a cadaver kidney continues to lengthen, and there is renewed debate about payment for living donors. To facilitate this debate, we studied what amount of payment would be cost-effective for society, i.e. what costs would be saved (if any) by removing a patient from the waiting list using a paid (living unrelated: LURD) donor-vendor. A Markov model was developed to calculate the expected average cost and outcome benefits of increasing the organ supply and reducing waiting times by adding paid LURD organs to the available pool. We found that a LURD transplant saved $94 579 (US dollars, 2002), and 3.5 quality-adjusted life years (QALYs) were gained. Adding the value of QALYs, a LURD transplant saved $269 319, assuming society values additional QALYs from transplantation at the rate paid per QALY while on dialysis. At a minimum, a vendor program would save society >$90000 per transplant and provides QALYs for the ESRD population. Thus, society could break even while paying $90 000/kidney vendor.
AB - The supply of kidneys does not meet the demand. As a consequence, the waiting time for a cadaver kidney continues to lengthen, and there is renewed debate about payment for living donors. To facilitate this debate, we studied what amount of payment would be cost-effective for society, i.e. what costs would be saved (if any) by removing a patient from the waiting list using a paid (living unrelated: LURD) donor-vendor. A Markov model was developed to calculate the expected average cost and outcome benefits of increasing the organ supply and reducing waiting times by adding paid LURD organs to the available pool. We found that a LURD transplant saved $94 579 (US dollars, 2002), and 3.5 quality-adjusted life years (QALYs) were gained. Adding the value of QALYs, a LURD transplant saved $269 319, assuming society values additional QALYs from transplantation at the rate paid per QALY while on dialysis. At a minimum, a vendor program would save society >$90000 per transplant and provides QALYs for the ESRD population. Thus, society could break even while paying $90 000/kidney vendor.
KW - Kidneys
KW - Living donor
KW - Payment
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U2 - 10.1046/j.1600-6143.2003.00290.x
DO - 10.1046/j.1600-6143.2003.00290.x
M3 - Article
C2 - 14974942
AN - SCOPUS:1342304066
SN - 1600-6135
VL - 4
SP - 216
EP - 221
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 2
ER -