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Cost-benefit approach in evaluating investment into donor action: the German case

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Transplant International

Abstract

Donor Action (DA) is an international initiative to help critical care units (CCUs) increase their own donation rates through improved-quality donation practices. Following a validated diagnostic review (DR), areas of weakness can be identified, and the appropriate changes introduced. Data gathered from a number of centers in nine European countries (including Germany) 1 year after the introduction of targeted improvement measures demonstrated a 59.2% (P=0.0015) increase in donation rates. This analysis computes the cost-benefit thresholds of implementing the DA methodology from a German health–economic point of view, taking into account the treatment alternatives for end-stage renal disease (dialysis and transplantation) and comparing the DA program with current organ-donation practice. Lifetime direct medical costs and quality-adjusted life years (QALYs) were calculated for both arms, considering only changes in cadaveric renal transplantation rates. If DA leads to a 59% overall increase in organ donation in Germany, the program will result in 33 QALYs and 1.8-million euros cost savings per million population (PMP). Therefore, DA would be cost-effective below 2.66-million euros implementation cost PMP (or 218-million euros for the whole country). As the partial implementation cost of the program was far below the threshold, DA is more cost-effective than other publicly reimbursed medical intervention.

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Acknowledgements

Donor Action is a collaborative initiative of the Eurotransplant International Foundation, the Organisación Nacional de Trasplantes and the Partnership for Organ Donation. The authors are indebted to G.G. Persijn and J. Smits for providing them with Eurotransplant survival data. Donor Action was developed with an educational grant from Novartis Pharma AG.

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Authors and Affiliations

  1. Donor Action Foundation, Prinsendreef 10, 3210, Linden, Belgium

    Leo Roels

  2. Transplantation and Immunology BU, Novartis Pharma AG, Basle, Switzerland

    Zoltán Kalo

  3. Deutsche Stiftung Organtransplantation, Munich, Germany

    Detlef Boesebeck

  4. Maine Medical Center, Maine Surgical Care Group, Portland, Maine, USA

    James Whiting

  5. Donor Action Foundation, London, Ontario, Canada

    Celia Wight

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  1. Leo Roels
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  2. Zoltán Kalo
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  3. Detlef Boesebeck
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  4. James Whiting
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  5. Celia Wight
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Correspondence to Leo Roels.

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Roels, L., Kalo, Z., Boesebeck, D. et al. Cost-benefit approach in evaluating investment into donor action: the German case. Transpl Int 16, 321–326 (2003). https://doi.org/10.1007/s00147-002-0535-5

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  • DOI: https://doi.org/10.1007/s00147-002-0535-5

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