Cost-effectiveness of lung transplantation in The Netherlands: a scenario analysis
STUDY OBJECTIVES: To calculate cost-effectiveness of scenarios concerning lung transplantation in The Netherlands. DESIGN: Microsimulation model predicting survival, quality of life, and costs with and without transplantation program, based on data of the Dutch lung transplantation program of 1990 to 1995. SETTING: Netherlands, University Hospital Groningen. PATIENTS: Included were 425 patients referred for lung transplantation, of whom 57 underwent transplantation. INTERVENTION: Lung transplantation. RESULTS: For the baseline scenario, the costs per life-year gained are G 194,000 (G=Netherlands guilders) and the costs per quality-adjusted life-year (QALY) gained are G 167,000. Restricting patient inflow ("policy scenario") lowers the costs per life-year gained: G 172,000 (costs per QALY gained: G 144,000). The supply of more donor lungs could reduce the costs per life-year gained to G 159,000 (G 135,000 per QALY gained; G1 =US $0.6, based on exchange rate at the time of the study). CONCLUSIONS: Lung transplantation is an expensive but effective intervention: survival and quality of life improve substantially after transplantation. The costs per life-year gained are relatively high, compared with other interventions and other types of transplantation. Restricting the patient inflow and/or raising donor supply improves cost-effectiveness to some degree. Limiting the extent of inpatient screening or lower future costs of immunosuppressives may slightly improve the cost-effectiveness of the program.
|Keywords||*Health Care Costs/trends, Cost-Benefit Analysis/trends, Follow-Up Studies, Humans, Lung Transplantation/*economics/mortality/psychology, Netherlands, Quality of Life, Respiratory Insufficiency/diagnosis/mortality/surgery, Retrospective Studies, Sensitivity and Specificity, Survival Rate, Tissue Donors|
Al, M.J., Koopmanschap, M.A., van Enckevort, P.J., Geertsma, A., van der Bij, W., de Boer, W.J., & TenVergert, E.M.. (1998). Cost-effectiveness of lung transplantation in The Netherlands: a scenario analysis. Chest: the cardiopulmonary and critical care journal. Retrieved from http://hdl.handle.net/1765/8762