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Kidney Week

Abstract: SA-PO046

Cost of Follow-Up Care within the First Year of Kidney Transplantation at the National Kidney and Transplant Institute

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical

Authors

  • Rey-Roxas, Irina Munoz, National Kidney and Transplant Institute, Quezon City, Philippines
  • Padilla, Benita S., National Kidney and Transplant Institute, Quezon City, Philippines
  • Casasola, Concesa, National Kidney and Transplant Institute, Quezon City, Philippines
  • Panelo, Carlo irwin Able, University of the Philippines Manila, Manila, Philippines
Background

The high cost of kidney transplantation (KT) and follow-up care contribute to the low rate of transplantation among Filipino End Stage Renal Disease (ESRD) patients. The cost of transplant procedures is better understood and provided basis for a transplant benefit package in the National Health Insurance Program. However, no studies on the cost of follow-up care, particularly on which subgroups of patients incur higher costs have been done in the Philippines. Objectives. This study aims to estimate the direct medical cost of follow-up care within the first year of kidney transplantation.

Methods

We analyzed records of 129 adult Filipino patients who underwent primary kidney transplant from June 2014 to May 2016 at the National Kidney and Transplant Institute (NKTI). A subgroup analysis based on immunologic risks as well as comorbidities using the Charlson comorbidity index (CCI) was also done. Direct costs of medical care were estimated by computing for the average cost of medical care consisting of professional fees, medicines and supplies, and diagnostics for both outpatient consults and hospital admissions.

Results

The estimated average direct cost of medical care within the first year of transplantation was PHP 655,616 (USD 13,312 based on USD1=PhP50) per patient. Those with high CCI incurred 46% higher average direct cost than those with low CCI (USD 17,899 vs USD 11259). Diabetics incurred 56% higher costs compared to non-diabetics (USD 20,237 vs USD 11,399). The difference in average cost between those with high immunologic risk and low immunologic risk was negligible. The cost of care showed a downward trend in the first year post KT, regardless of immunologic risk or CCI score. For outpatient care, medications (85%) was the main cost driver while for admitted cases it was diagnostic work-up (37%).

Conclusion

The high cost of outpatient medications, especially for immunosuppressive drugs and insulin therapy, indicate the need for financing of follow-up care after kidney transplantation. A prospective study with a span of more than a year is needed to better understand the cost of follow up care after transplantation.