title: Cost analysis of human islet transplantation for the treatment of type 1 diabetes in the Swiss-French Consortium GRAGIL.
abstract: OBJECTIVE
  To evaluate the cost of islet transplantation in type 1 diabetic patients with a functional renal graft in a multicenter network.
  
  
  METHODS
  The study involved nine diabetic patients transplanted in the Swiss-French Groupe Rhône-Alpes, Rhin et Geneve pour la transplantation d'Ilots Langerhans (GRAGIL) consortium between March 1999 and June 2000. The direct medical costs were estimated from Social Security's perspective from the inclusion of the patient to 1 year after transplantation. All cost components were computed separately and included evaluation, screening and candidacy, organ retrieval, islet processing, pancreas and islet transportation, hospitalization for transplantation, follow-up, medications (immunosuppressive, antidiabetic, and adjuvant drugs), and adverse events requiring hospitalization.
  
  
  RESULTS
  During the study period, 56 pancreata were processed and 14 islet preparations were transplanted. The average cost of an islet transplantation (procedure and 1-year follow-up) was 77,745 euro (French rate, year 2000). The four main cost components were islet preparation (30% of the total cost), adverse events (24%), drugs (14%), and hospitalization (13%).
  
  
  CONCLUSIONS
  Overall costs of islet transplantation are slightly higher than those of pancreas transplantation. The cell isolation process is a critical point; a reduction in overall cost will require more efficient ways of isolating high yields of viable islets. Costs generated by shipments within the GRAGIL network did not represent an economic burden. It can be expected that the costs will decrease with growing experience and improving technology.
authors.affiliation: Department of Medical Information, Hospices Civils, Lyon, France. adrienne.guignard@chu-lyons.fr
authors.forename: Adrienne P
authors.initials: AP
authors.lastname: Guignard
authors.forename: José
authors.initials: J
authors.lastname: Oberholzer
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Benhamou
authors.forename: Sandrine
authors.initials: S
authors.lastname: Touzet
authors.forename: Pascal
authors.initials: P
authors.lastname: Bucher
authors.forename: Alfred
authors.initials: A
authors.lastname: Penfornis
authors.forename: François
authors.initials: F
authors.lastname: Bayle
authors.forename: Laurence
authors.initials: L
authors.lastname: Kessler
authors.forename: Charles
authors.initials: C
authors.lastname: Thivolet
authors.forename: Lionel
authors.initials: L
authors.lastname: Badet
authors.forename: Philippe
authors.initials: P
authors.lastname: Morel
authors.forename: Cyril
authors.initials: C
authors.lastname: Colin
mesh_terms: D017024:Chemotherapy, Adjuvant / Q000191:economics; D003365:Costs and Cost Analysis; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000601:surgery*; D005602:France; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007165:Immunosuppression Therapy / Q000191:economics; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects / Q000191:economics*; D016030:Kidney Transplantation; D013557:Switzerland; D020858:Tissue and Organ Harvesting / Q000191:economics; D009927:Tissue and Organ Procurement / Q000191:economics