METHODS: . Mixed design of a retrospective single arm cohort study and a predictive Markov model. Patients who had undergone a kidney transplant and receiving care were identified. 114 files were selected using simple random sampling with replacement. A data abstraction tool was used to collect bio data and resources used. An interview guide to obtain tender prices and service charges levied. Data was entered into an Excel based database and descriptive analysis done using STATA version 10. A micro ingredient approach was used to cost all the resources used to manage kidney transplant recipients (KTRs). These were used to compute the total expenditure incurred by each patient per year. The contribution of each cost category was computed. Budget impact analysis was done.

RESULTS: . Immunosuppressants, laboratory investigations and services contributed significantly to the total cost of post-kidney transplant care (PKTC). Expenditure was highest in year 1 at a cost of Ksh 32,882 per patient per month (PPPM) followed by year 3 at Ksh 25,639 (PPPM)and the trend decreased gradually from year 1 to year 5. The annual medicine and hospital budgets increased by Ksh 369,568,640 and Ksh 3,824,569,720 respectively over 5 years. The NHIF Outpatient budget increased from Ksh 175,729,217 in year 1 to Ksh 275,508,106 in year 5 an increment of Ksh 99,778,889. CONCLUSION. The main expenditure drivers were immunosuppressants, laboratory investigations and services. These costs can be comfortable factored into the NHIF benefit package.