OBJECTIVES : Quantify direct non-medical and indirect costs for the first year after transplantation in a real-life Thai context.

METHODS : 87 kidney and 67 bone marrow transplant recipients who were followed-up at least 1-year after transplantation from 3 kidney and 2 bone marrow transplant centers were interviewed based on the data record form. Direct non-medical costs regarding traveling to centers, out-of-pocket payments for food, and accommodation were obtained. Despite of the income from survey wages, the productivity loss was measured from Thai Gross National Income (GNI) per capita per day to mitigate uncertainty multiplied by work time loss or the period of absence (in a half or full day). The consumer price index was used to adjust GNI base year to 2018. Mean and standard error (SE) was used to estimate the costs for both patients and caregivers.

RESULTS : The mean of daily traveling costs were 400.4286 THB (SE=28.1833). The incremental costs for daily food were 162.7792 THB (SE=13.6701) and the annual accommodation were 402.2727 THB (SE=200.2631). The average number of caregivers for outpatient and inpatient visit per day were 0.6461 and 1.0260, respectively and the work time loss of caregivers were 0.8896 days for OPD visit and 0.3831 days for each time visiting hospitalized recipients. The daily productivity loss for a recipient and caregivers were estimated regarding GNI as 347.5831, and 189.0142 THB, respectively. Thai transplant centers were located only in the university area. Thus, theses type of costs presented the particular values for the population.

CONCLUSIONS : Transplantation is the resource-intensive utilization. Recipients and caregivers also consume the direct non-medical and indirect costs due to follow-up for laboratory monitoring, medication, or readmission. This study provides real-life evidences on their constraints. The direct non-medical and indirect costs can be the model parameters for the further cost-effectiveness analysis of any posttransplant care technologies for accessibility decision.