OBJECTIVE: This study was undertaken to determine the cost per quality-adjusted life-year gained with lung transplantation relative to medical treatment for end-stage lung disease in the United Kingdom. METHODS: Patients on the transplant waiting list were used to represent medical treatment. Four-year national survival data were extrapolated to 15 years by means of parametric techniques. Quality-adjusted life-years were derived by means of utility scores obtained from a cross-section of patients. Resource consumption and costs were based on local and national sources. Costs and benefits were discounted at an annual rate of 6%. RESULTS: Across a 15-year period lung transplantation yielded mean benefits (relative to medical treatment) of 2.1, 3.3, and 3.6 quality-adjusted life-years for single-lung, double-lung, and heart-lung transplantation, respectively. During the same period the mean cost of medical treatment was estimated at $73,564, compared with $176,640, $180,528, and $178,387 for single-lung, double-lung, and heart-lung transplantation, respectively. The costs per quality-adjusted life-year gained were $48,241 for single-lung, $32,803 for double-lung, and $29,285 for heart-lung transplantation. Sensitivity analysis found the principal determinants of cost-effectiveness to be quality of life and maintenance costs after transplantation. CONCLUSIONS: Lung transplantation results in survival and quality of life gains but remains expensive, with cost-effectiveness limited by substantial mortality and morbidity and high costs. The cost-effectiveness of lung transplantation can be improved with lowered immunosuppression costs and improvements in quality of life after transplantation.
OBJECTIVE: This study was undertaken to determine the cost per quality-adjusted life-year gained with lung transplantation relative to medical treatment for end-stage lung disease in the United Kingdom. METHODS:Patients on the transplant waiting list were used to represent medical treatment. Four-year national survival data were extrapolated to 15 years by means of parametric techniques. Quality-adjusted life-years were derived by means of utility scores obtained from a cross-section of patients. Resource consumption and costs were based on local and national sources. Costs and benefits were discounted at an annual rate of 6%. RESULTS: Across a 15-year period lung transplantation yielded mean benefits (relative to medical treatment) of 2.1, 3.3, and 3.6 quality-adjusted life-years for single-lung, double-lung, and heart-lung transplantation, respectively. During the same period the mean cost of medical treatment was estimated at $73,564, compared with $176,640, $180,528, and $178,387 for single-lung, double-lung, and heart-lung transplantation, respectively. The costs per quality-adjusted life-year gained were $48,241 for single-lung, $32,803 for double-lung, and $29,285 for heart-lung transplantation. Sensitivity analysis found the principal determinants of cost-effectiveness to be quality of life and maintenance costs after transplantation. CONCLUSIONS: Lung transplantation results in survival and quality of life gains but remains expensive, with cost-effectiveness limited by substantial mortality and morbidity and high costs. The cost-effectiveness of lung transplantation can be improved with lowered immunosuppression costs and improvements in quality of life after transplantation.
Authors: Akiko M Saito; Corey Cutler; David Zahrieh; Robert J Soiffer; Vincent T Ho; Edwin P Alyea; John Koreth; Joseph H Antin; Stephanie J Lee Journal: Biol Blood Marrow Transplant Date: 2008-02 Impact factor: 5.742
Authors: George J Arnaoutakis; Jeremiah G Allen; Christian A Merlo; Brigitte E Sullivan; William A Baumgartner; John V Conte; Ashish S Shah Journal: J Heart Lung Transplant Date: 2010-09-24 Impact factor: 10.247
Authors: Lisa Mellon; Frank Doyle; Anne Hickey; Kenneth D Ward; Declan G de Freitas; P Aiden McCormick; Oisin O'Connell; Peter Conlon Journal: Cochrane Database Syst Rev Date: 2022-09-12
Authors: Vanessa Silva E Silva; Janine Schirmer; Bartira D'Aguiar Roza; Priscilla Caroliny de Oliveira; Sonny Dhanani; Joan Almost; Markus Schafer; Joan Tranmer Journal: Can J Kidney Health Dis Date: 2021-02-20