The cost effectiveness of lung transplantation compared with that of heart and liver transplantation in the Netherlands

Abstract

This study was performed to assess the main reasons for the unfavorable cost effectiveness of lung transplantation compared with that of heart and liver transplantation. Costs, effects, and cost-effectiveness ratios of Dutch lung, heart, and liver transplantation programs were compared. The data are based on three Dutch technology assessments of transplantation, with minor adjustments for time and methods. In result, mainly follow-up costs of lung transplantation are higher than costs of heart and liver transplantation-- 50,300 US dollars, 121,500 US dollars, and 95,300 US dollars, respectively--in the first 3 years after transplantation. The survival gain realized by lung transplantation is small (4.4 years) compared with heart (8.8 years) and liver (14.7 years) transplantation. Costs per life-year gained were 77,000 US dollars, 38,000 US dollars, and 26,000 US dollars for lung, heart, and liver transplantation, respectively. The unfavorable cost effectiveness of lung transplantation is largely related to a relatively small survival gain and high follow-up costs.