Cost analysis of human islet transplantation for the treatment of type 1 diabetes in the Swiss-French Consortium GRAGIL.
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.
Guignard
Adrienne P
AP
Department of Medical Information, Hospices Civils, Lyon, France. adrienne.guignard@chu-lyons.fr
Oberholzer
José
J
Benhamou
Pierre-Yves
PY
Touzet
Sandrine
S
Bucher
Pascal
P
Penfornis
Alfred
A
Bayle
François
F
Kessler
Laurence
L
Thivolet
Charles
C
Badet
Lionel
L
Morel
Philippe
P
Colin
Cyril
C
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