Quantifying spillover benefits in value assessment: a case study of increased graft survival on the US kidney transplant waitlist

Abstract

Aim: To quantify the wider impacts of increased graft survival on the size of the kidney transplant waitlist and health and economic outcomes. Materials and Methods:The analysis employed steady-state solutions and a simulation version of a double-queuing model. Baseline input parameters were sourced from the Organ Procurement and Transplant Network and the United States Renal Data System. Three increased graft survival scenarios were modeled: decreases in repeat transplant candidates joining the waitlist of 25%, 50%, and 100%.Results: Under the three scenarios, we estimated that the US waitlist size would decrease from 91,822 to 85,461 (6.9% decrease), 80,073 (12.8% decrease), and 69,340 (24.4% decrease), respectively. Patient outcomes improved, with lifetime quality-adjusted life years (QALYs) for a one-year cohort of transplant recipients increasing by 10,010, 16,888, and 43,345 over the three scenarios.