Cost-Effectiveness of Organ Donation: Evaluating Investment into Donor Action and Other Donor Initiatives

Abstract

Initiatives aimed at increasing organ donation can be considered health care interventions, and will compete with other health care interventions for limited resources. We have developed a model capable of calculating the cost-utility of organ donor initiatives and applied it to Donor Action, a successful international program designed to optimize donor practices.The perspective of the payer in the Canadian health care system was chosen. A Markov model was developed to estimate the net present value incremental lifetime direct medical costs and quality adjusted life years (QALYs) as a consequence of increased kidney transplantation rates. Cost-saving and costeffectiveness thresholds were calculated. The effects of changing the success rate and time frame of the intervention was examined as a sensitivity analysis.Transplantation results in a gain of 1.99 QALYs and a cost savings of Can$104 000 over the 20-year time frame compared with waiting on dialysis. Implementation of an intervention such as Donor Action, which produced as few as three extra donors per million population, would be cost-effective at a cost of Can$ 1.0 million per million population.The cost-effectiveness of Donor Action and other organ donor initiatives compare favorably to other health care interventions. Organ donation may be underfunded in North America.

The Cost-Effectiveness of Using Payment to Increase Living Donor Kidneys for Transplantation

“…Although kidney transplantation has been shown to improve outcomes and reduce health care costs compared with dialysis, there is limited information on the cost-effectiveness of additional investment into strategies that may potentially increase the rate of kidney transplantation (11)(12)(13). Because previous studies suggest that financial barriers exist to donating organs, providing financial incentives might be an effective strategy for increasing donation rates, which is further supported by our recent survey results.…”

The Effectiveness of High- and Low-Intensity Worksite Campaigns to Promote Organ Donation: The Workplace Partnership for Life

“…This number constitutes thousands of employees*that is, state residents*who have declared their desire to donate their organs after their death. Increases of this size potentially equate to hundreds of lives saved through donation by this set of worksite campaigns alone, albeit over the lifetimes of potential new donors, which in turn translates into millions of dollars saved in health care costs annually for the chronically ill people who will receive transplants (Whiting et al, 2004). Clearly, this constitutes a highly cost-effective means of saving and improving lives.…”

“…In spite of the additional expense involved with devoting staff time for the planning and coordination of activities needed to conduct on-site events, the opportunity to interact face-to-face with staff and volunteers has the potential, at least in the case of organ donation, of doubling the desired behavioral outcomes when compared to disseminating health messages through traditional media channels. Considering that multiple estimates converge on a net average worth of each new donor to be approximately $1M in medical savings and Quality-Adjusted Life Years (QALY) (Mendeloff, Ko, Roberts, Byrne, & Dew, 2004;Whiting et al, 2004), there is every indication that the costs associated with increasing the number of new registrations through large-scale, effective campaigns are minimal by comparison with the benefits.…”

Impact of Diabetes and Hepatitis after Kidney Transplantation on Patients Who Are Affected by Hepatitis C Virus

“…The average expected number of life-years through 20 y posttransplantation in a patient cohort were estimated using methods developed previously (17)(18)(19)(20). Briefly, expected life-years after transplantation are the area under the posttransplantation patient survival functions.…”