Presentation (CTI)

OBJECTIVES: Kidney transplantation is the gold standard treatment for End Stage Kidney Disease. This study aimed to estimate the cost of kidney transplant patients in Portugal from a societal perspective.
METHODS: Mean costs of a transplanted patient were estimated based on the resource use from the time of entry on the transplant waiting list until death. Costs were estimated from a societal perspective. Four periods were considered: transplant waiting list, transplant procedure, post-transplant, and after graft loss. The annual consumption of resources for each period was calculated according to Diagnosis Related Groups (DRG) database analysis for inpatient care and on an expert panel opinion for outpatient care. The length of each period was obtained from the Portuguese Renal Transplant Registry (waiting list and graft survival) and the 2022 European Renal Association Annual Report (survival after transplantation). Prices were obtained from official sources. Indirect costs were established following the human capital approach and supported by inputs from an expert panel.
RESULTS: The mean estimated cost of a transplanted patient was €261,047, with 73% direct and 27% (€69,565) indirect costs, respectively. The cost of the 4-year waiting list was €6,280 (3%), the kidney transplant procedure was estimated at €22,161 (12%), the post-transplant period (17.5 years, which included hospital visits, diagnostic tests, readmissions, and drug therapy) represented €72,965 (38%) and the estimated costs for patients experiencing graft loss (50% of patients after 17 years) were €87,448 (46%), including costs of retransplantation and dialysis.
CONCLUSIONS: The patient mean survival after a kidney transplant was 17.5 years. The cost of a kidney transplant patient was about €261,000, with direct costs representing 73% (€191,482). Almost half of this value is related to care after graft loss. The value of preventing graft loss needs to be rigorously evaluated considering its cost implications.