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Abstract: SA-PO838

Preemptive Kidney Transplants Lead to Cost Savings in Less Than a Year

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Dhawan, Rahul, Optum Inc, Eden Prairie, Minnesota, United States
  • Crossman, Ashley, Optum Inc, Eden Prairie, Minnesota, United States
  • Wysocky, Gregory, Optum Inc, Eden Prairie, Minnesota, United States
  • Tao, Jiang, Optum Inc, Eden Prairie, Minnesota, United States
  • Plosser, Kevin, Optum Inc, Eden Prairie, Minnesota, United States

Group or Team Name

  • Optum KRS Nurses and Product Team and the OHS Medical Office Team
Background

For patients living with chronic kidney disease (CKD), it is theorized that receiving a kidney transplant before they need to start dialysis allows them to stay healthier and live longer than if they were to receive a transplant after initiating dialysis.1 The current study assessed the cost savings associated with a preemptive kidney transplant, when available.

Methods

The study population consisted of patients drawn from a national health plan claims database who were identified as having stage 4–5 CKD and either received a kidney transplant prior to initiating dialysis (N = 249) or initiated dialysis (N = 1,657) between July 2017 and June 2020. To measure the total costs avoided by preemptively transplanting a kidney, the difference between an ESRD per member per month and a post-transplant per member per month was analyzed while adjusting for member retention.

Results

For members initiating dialysis, incident ESRD per diseased member per month (PDMPM) was calculated as the mean medical allowed amount for each of the first 6 months following the ESRD start date. The average PDMPM for the first 6 months was $24,308, and $18,465 each month after six months. Using the mean cost of a kidney transplant of $109,513, the costs of the transplant are offset within the first 7 months. If the member is retained on the health plan for at least 1 year, the transplant results in $211,000 in avoided medical expenditures and a net 1-year savings of $101,800 after the cost of the transplant.

Conclusion

Preemptive kidney transplants for patients with CKD have numerous benefits, including higher patient survival, improved quality of life and significant cost savings. Transitioning a patient to dialysis costs as much as $211,000 per year. While the cost of transplantation is around $110,000, those costs are offset after less than seven months due to avoidance of dialysis and other health complications. Preemptive transplants therefore greatly benefit the patient and can also allow for cost savings.