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Experts disagree on how more transplants affect healthcare costs.
After the yes to the transplantation law and the so-called contradiction solution, the SRF community is concerned with one question: namely, whether additional organ donations will increase the costs for the health system and health insurance premiums. Two experts answer this question – and do not agree on all points.
The kidney as an example of cost reduction
The Federal Council had already taken a clear position on this before the vote. In a 2020 published Message from the Federal Council a possible cost reduction using the example of kidneys was pointed out. “Kidney transplantation increases life expectancy in chronic kidney disease compared to dialysis, improves quality of life and is also less expensive for society,” the letter says.
For Franz Immer, Director of Swisstransplant, it is also clear that the costs in the health care system will fall in the medium to long term with the yes to the objection solution. It is known that transplantation is a very cost-effective treatment, especially for kidney transplants. “We assume that the number of donors will increase in the medium to long term and thus the transplantation activity.”
Taking the kidney as an example, it can be said clearly that the costs will fall because these patients are on dialysis, the blood wash. If this blood washing is eliminated with a kidney transplant, then you will certainly save around 100,000 francs in costs per year. A kidney works for 20 years and the transplantation costs are lower than the dialysis costs. “This means that every transplanted kidney saves a total of around 1.5 million health costs and restores a good quality of life and ability to work,” says Immer.
Falling costs are also possible for other transplants
But how is kidney transplantation representative of the overall reduction in the cost of transplantation? For heart and liver transplants, Immer also expects the costs to decrease.
Since in these transplantations the patients are usually already very ill before they can be transplanted, there are high healthcare costs up to the transplantation. The Swisstransplant director therefore argues that a cost effect can also be expected here if transplants can be carried out more frequently and quickly.
Only indirect costs could decrease
Jürg Steiger, chief physician for transplantation immunology at the University Hospital Basel, is less optimistic. Because the pure health costs would probably not decrease if, for example, more liver transplants are carried out. “Of course, you don’t have to stay in intensive care for as long as when someone dies of liver failure,” argues Steiger. But if someone were to live another 20 to 30 years with this liver, the drug costs would add up – that would be around 10,000 to 20,000 francs a year.
However, Steiger agrees that, according to calculations, the indirect costs could actually decrease because affected patients could remain able to work through a transplant.