KIDNEY TRANSPLANT REALLOCATION: QUANTIFYING COST SAVINGS AND QALY GAINS FROM DISEASE-MODIFYING TREATMENTS FOR THE UK NHS
Author(s)
Zalmai Hakimi, PharmD, PhD1, Carly Rich, BSc, MSc, PhD1, Michal Gorecki, MSc2, Jameel Nazir, PhD1, Michal Pochopien, PhD2.
1Sobi, Stockholm, Sweden, 2Clever Access, Krakow, Poland.
1Sobi, Stockholm, Sweden, 2Clever Access, Krakow, Poland.
OBJECTIVES: Complement 3 glomerulopathy (C3G) and immune complex membranoproliferative glomerulonephritis (IC-MPGN) are associated with rapid progression to kidney failure, often requiring dialysis or transplantation within a decade of diagnosis. Disease-modifying treatments (DMTs) may delay or prevent kidney progression and reduce overall burden. Given the scarcity of donor kidneys, transplants spared through DMT use could potentially be reallocated to other patients with chronic kidney disease (CKD). This analysis aimed to quantify the potential costs and health benefits associated with such reallocation.
METHODS: A targeted literature review was conducted to identify UK-specific estimates of costs, quality-adjusted life years (QALYs), and waiting times associated with kidney transplantation in patients with CKD. A model was developed from the UK National Health Service (NHS) perspective to estimate the incremental costs and QALY benefits from reallocating each transplant potentially spared through DMT use compared with standard of care.
RESULTS: Each kidney spared by DMT use and reallocated to a patient with CKD on the transplant waiting list was associated with an estimated direct cost saving of £24,100 per year and a QALY gain of 0.231 per year. Over a 10-year horizon (reflecting the median kidney transplant survival), this corresponded to cumulative savings of approximately £241,000 and an additional 2.31 QALYs per kidney reallocated.
CONCLUSIONS: To our knowledge, this is the first analysis to quantify both NHS cost savings and QALY gains associated with kidney transplant reallocation in the context of DMTs for C3G and IC-MPGN. These findings highlight the broader system-level benefits of treatments that preserve native kidney function - value extending beyond the treated patient to others awaiting transplantation. Health technology assessment bodies, payers, and clinicians should consider these reallocation benefits when evaluating the overall value of emerging therapies for rare kidney disease.
METHODS: A targeted literature review was conducted to identify UK-specific estimates of costs, quality-adjusted life years (QALYs), and waiting times associated with kidney transplantation in patients with CKD. A model was developed from the UK National Health Service (NHS) perspective to estimate the incremental costs and QALY benefits from reallocating each transplant potentially spared through DMT use compared with standard of care.
RESULTS: Each kidney spared by DMT use and reallocated to a patient with CKD on the transplant waiting list was associated with an estimated direct cost saving of £24,100 per year and a QALY gain of 0.231 per year. Over a 10-year horizon (reflecting the median kidney transplant survival), this corresponded to cumulative savings of approximately £241,000 and an additional 2.31 QALYs per kidney reallocated.
CONCLUSIONS: To our knowledge, this is the first analysis to quantify both NHS cost savings and QALY gains associated with kidney transplant reallocation in the context of DMTs for C3G and IC-MPGN. These findings highlight the broader system-level benefits of treatments that preserve native kidney function - value extending beyond the treated patient to others awaiting transplantation. Health technology assessment bodies, payers, and clinicians should consider these reallocation benefits when evaluating the overall value of emerging therapies for rare kidney disease.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE438
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Rare & Orphan Diseases, Urinary/Kidney Disorders