Cost-effetiveness analysis of a simultaneous pancreas-kidney prgram in philantropic institution

The simultaneous pancreas-kidney transplant (SPKT) is one therapeutic option for diabetic patients with end stage renal disease. To conduct a cost-effectiveness analysis of a SPKT program in a private Hospital financed by the Public Health System. We conducted a retrospective analysis where we included all patients that underwent SPKT from 2002 to 2015. We collected data about costs per patient including the pre transplant phase (elegibility evaluation for the transplant, listing and outpatient follow up), the transplant and post-transplant phases. For the survival analysis we used the Kaplan-Meier method and generated a survival curve from the SPKT date to death. For the cost-effectiveness analysis we used the following calculations: 1. Calculation of average cost for each year of life saved = (average total cost/mean survival time); 2. Calculation of lifespan in years for the repayment of the transplant by the recipient = (average total cost /GDP per capta); 3. Calculation of wealth production after the transplant [(mean survival time) – (average total cost /GDP per capta)*GDP per capta]. The values of GDP per capta and dollar exchange rate were the ones from 11/2015, being US $6.981,79 and BRL 3,90, respectively. 143 patients with the mean age of 36.3 years were included, 52% of those being male. The average total cost, pre-transplant, transplant and post-transplant costs were $ 51.341,70, $738.29, $19.432,15 e $ 31.171,26, respectively. The mean survival time has been 13.4 years. The average cost for each year of life saved was $ 3.825,76 and 7.35 years of lifespan would be necessary for the treatment to be paid off. There would still be 6 years for the recipient to produce wealth, generating $42.353,99 during that timespan. The SPKT was considered cost-effective once it has generated enough survival results to cover the transplant costs and still generate wealth for the country.