TRANSPLANTATION COST EFFECTIVENESS
- Kidney transplantation is highly cost-effective, particularly in relation to NHS spend, and is the treatment of choice for many patients with end-stage renal failure.
- The indicative cost of maintaining a patient with end-stage renal failure on renal replacement therapy (dialysis) is £17,500 per patient per year for a patient on peritoneal dialysis and £35,000 per patient per year for a patient on hospital haemodialysis.
- There are over 37,800 patients with end-stage renal failure in the UK. Nearly 21,000 are on dialysis, whilst the remainder have a transplant. Of those on dialysis, 76% are on haemodialysis and 24% on peritoneal dialysis.
- The average cost of dialysis is £30,800 per patient per year.
- 3% of the NHS budget is spent on kidney failure services.
- The indicative cost of a kidney transplant (including induction therapy but excluding NHSBT costs) is £17,000 per patient per transplant.
- The immuno-suppression required by a patient with a transplant costs £5,000 per patient per year.
- Kidney transplantation leads to a cost benefit in the second and subsequent years of £25,800 pa.
- The cost benefit of kidney transplantation compared to dialysis over a period of ten years (the median transplant survival time) is £241,000 or £24,100 per year for each year that the patient has a functioning transplanted kidney.
- In 2008-09, 2,497 people received a kidney transplant. These transplants are now saving the NHS £50.3m in dialysis costs each year for every year that the kidney functions.
- In 2008-09, 215 more kidney transplants were provided than in the previous year. These transplants are now saving the NHS £4.5m every year until graft failure.
- At the end of March 2009, the UK Transplant Registry had records of over 23,000 people in the United Kingdom with a functioning kidney transplant. In this year, these patients will save the NHS over £512m in the dialysis costs that they would need if they did not have a functioning kidney transplant.
- On 1 April 2009 there were 6,920 patients waiting for a transplant of which the majority will be on dialysis, costing around £193m per year. If all of these patients received a transplant, the approximate cost would be £41m per year, which represents a saving to the NHS of £152m per year.
References and notes: many figures are approximate. In particular, data on the costs of dialysis, transplantation and immuno-suppression can differ quite markedly between patients.
- Economic evaluation of end-stage renal disease treatment. G Ardine de Wit, P Ramsteijn and F de Charro, Health Policy 44, 1998, pp215-232.
- UK Renal Registry.
- UK Renal Registry, Eighth Annual Report December 2005.
- A weighted average of the cost of dialysis based on 76% of patients receiving haemodialysis.
- Estimated tariff for renal transplantation in England (to be updated later in 2009)
- Based on NICE assessment of the clinical and cost effectiveness of home and hospital haemodialysis for patients with end stage renal failure, 2004.
- NHSBT - Organ Donation & Transplantation, based on adult cadaveric kidney-only graft recipients of transplants carried out in 1992-1994.
- NHSBT - Organ Donation & Transplantation, Activity Report 2008-2009.
- NHSBT - Organ Donation & Transplantation.
- NHSBT - Organ Donation & Transplantation, based on number of patients in the UK with a functioning kidney transplant, who have not been lost to follow-up or have died, and whose last assessment date was after January 2005.
- Based on the cost of a transplant and ten years of immuno-suppression, averaged over ten years.
Last updated February 2010