title: Costs of Treatment after Renal Transplantation: Is it Worth to Pay More?
abstract: The primary aim of the study was to estimate costs of treatment for the first year after renal transplantation from the perspective of health insurance organizations in Iran. An Excel-based and a Monte Carlo model were developed to determine the treatment costs of current clinical practice in renal transplantation therapy (RTT). Inputs were derived from Ministry of Health and insurance organizations database, hospital and pharmacy records, clinical trials and local and international literature. According to the model, there were almost 17,000 patients receiving RTT in Iran, out of which about 2,200 patients underwent the operation within the study year (2011 - 2012; n = 2,200) The estimated first year total treatment cost after renal transplantation was almost $14,000,000. These costs corresponded to annual total cost per patient of almost $6500 for the payers. Renal transplantation therapy is almost fully reimbursed by government in Iran. However, regarding new expensive medicines, cost of medical expenditure is rapidly growing and becoming quite unaffordable for the government; therefore, out-of-pocket (OOP) payments are dramatically increasing over time. In order to improve reimbursement policy making under pressure of current budget constraints, the present study is providing decision makers with practical tools make it possible for them to easily compare budgetary impact of the current therapy strategy with the future financial consequences of purchasing newly proposed medicines. In other words having estimation of the current budget spending on RTT would help policy makers in making efficient resource allocation and decrease quite high OOP expenditures.
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Salamzadeh
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Naghmeh
authors.initials: N
authors.lastname: Foroutan
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Jamshidi
authors.affiliation: Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Rasekh
authors.affiliation: Tarbiat Modares University.
authors.forename: Ali
authors.initials: A
authors.lastname: Rajabzadeh Gatari
authors.affiliation: School of Pharmacy, Tehran University of Medical Sciences.
authors.forename: Arash
authors.initials: A
authors.lastname: Foroutan
authors.affiliation: Department of Kidney Transplantation, Urology Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Nafar
keywords: Budget; Cost; Insurance; Policy making; Renal transplantation therapy
references.citation: Vojnosanit Pregl. 2009 Aug;66(8):639-44
references.pmid: 19780419
references.citation: Transplantation. 1999 Apr 15;67(7):1036-42
references.pmid: 10221490
references.citation: Transplant Proc. 2007 May;39(4):1044-7
references.pmid: 17524887
references.citation: Iran J Kidney Dis. 2009 Apr;3(2):103-8
references.pmid: 19395787
references.citation: Bull World Health Organ. 2008 Mar;86(3):229-37
references.pmid: 18368211
references.citation: Nephrol Dial Transplant. 1999 Oct;14(10):2332-42
references.pmid: 10528655
references.citation: Iran J Pharm Res. 2012 Winter;11(1):1-2
references.pmid: 25317179
references.citation: Iran J Kidney Dis. 2012 Jul;6(4):300-6
references.pmid: 22797101
references.citation: Exp Clin Transplant. 2011 Feb;9(1):42-9
references.pmid: 21605022
references.citation: Kidney Int. 2010 Dec;78(11):1068-74
references.pmid: 20703217
references.citation: Int J Health Care Finance Econ. 2011 Dec;11(4):267-85
references.pmid: 21915727
references.citation: Clinicoecon Outcomes Res. 2013 Oct 18;5:545-53
references.pmid: 24159260
references.citation: Urol J. 2007 Spring;4(2):66-70
references.pmid: 17701924
references.citation: J Nephropathol. 2012 Apr;1(1):5-10
references.pmid: 24475379
references.citation: Iran J Pharm Res. 2012 Winter;11(1):171-5
references.pmid: 24250439
references.citation: Transplant Proc. 2007 May;39(4):1071-3
references.pmid: 17524894
references.citation: Arab J Nephrol Transplant. 2012 Jan;5(1):19-24
references.pmid: 22283862
references.citation: Int J Technol Assess Health Care. 1995 Summer;11(3):611-22
references.pmid: 7591556
references.citation: Value Health. 2007 Sep-Oct;10(5):336-47
references.pmid: 17888098
references.citation: Am J Transplant. 2007 Nov;7(11):2522-31
references.pmid: 17868057
references.citation: Iran J Kidney Dis. 2008 Oct;2(4):183-92
references.pmid: 19377235