Cost-utility of lung transplantation: a pilot study.
BACKGROUND
The purpose of this study was to conduct a pilot investigation of the cost-utility of lung transplantation. With this study we provide a threshold analysis to estimate the survival gains that must be achieved for lung transplantation to be considered a beneficial use of society's resources.


METHODS
A cross-sectional cohort design was used. All patients having undergone lung transplantation at the University of Pittsburgh Medical Center between March 1 and August 31, 1994, were identified via roster of transplant recipients (n = 20). Surviving patients were interviewed, by telephone, at their 1-year anniversary date. Utility was assessed by use of the quality of well-being scale. Direct cost of care was estimated from adjusted charges for the surgical admission, plus physician fees per the Medicare Physician Fee Schedule.


RESULTS
The mean quality of well-being score for this group was 0.54 +/- 0.198 SD (median = 0.599, range 0 to 0.728). Summing the physician cost and the adjusted charges for the inpatient operative admission, the average cost of lung transplantation was $153,921 +/- $133,981 SD (median $94,324, range $63,405 to $598,482). At a cost of $94,324 and a utility of 0.599, the survival gain from surgery must be 2.7 years for the cost of the procedure to be justified from a societal perspective.


CONCLUSIONS
Because of the many limitations in this pilot study, no firm policy implication may be drawn from these data. Directions for future research are discussed.
Gartner
S H
SH
Presbyterian University Hospital, Pittsburgh, Pennsylvania, USA.
Sevick
M A
MA
Keenan
R J
RJ
Chen
G J
GJ
D000328:Adult; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D005251:Fees, Medical; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016040:Lung Transplantation / Q000191:economics*; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D010865:Pilot Projects; D011788:Quality of Life; D013689:Telephone