Analyzes in various countries of the world agree
In transplantation medicine
Enables significant economic savings, but...
A large number of organ transplants carried out so far (about 1.5 mill.) Have brought significant medical experiences, developed an organization of organ harvesting and transplantation affirmed as a rational and effective way of treating and preserving the health and life of a large number of patients. Transplant medicine is generally accepted, and its results are greatly improved over time. Advancements in immunosuppression have brought additional important qualitative changes.
The transplanted kidney from the living donor has survival longer than about 20% compared to the cadaveric kidney. But a sling from a live provider implies many additional, and many, unnecessary costs in selecting a donor. Quality of life is an important growth for transplanted people, and the viability of transplantation has increased
A large number of organ transplants carried out so far (about 1.5 mill.) Have brought significant medical experiences, developed an organization of organ harvesting and transplantation affirmed as a rational and effective way of treating and preserving the health and life of a large number of patients. Transplant medicine is generally accepted, and its results are greatly improved over time. Advancements in immunosuppression have brought additional important qualitative changes.
The transplanted kidney from the living donor has survival longer than about 20% compared to the cadaveric kidney. But a sling from a live provider implies many additional, and many, unnecessary costs in selecting a donor. Quality of life is an important growth for transplanted people, and the viability of transplantation has increased
What is your opinion about cost benefit of organ transplantation?
What is your opinion about cost benefit of organ transplantation in Bosnia and Herzegovina?
Which part of entire costs do takes immunosupressive drugs in transplantation process ?
Have you considered the complement reaction between two spacies in xenotransplantation, regardless immunosupression or the cost benefits it provides?
I did not understand the best, Your question on what exactly do you think of complement and its reaction between two species colleague dr. Aganovic on the complement in possible future xenotransplantation?
What is the cost benefit of organ transplantation?. Available from: https://www.researchgate.net/post/What_is_the_cost_benefit_of_organ_transplantation2#5901bfa3615e273c7a5a5304 [accessed Apr 27, 2017].
Answer for dr.Marina-Delic-Sarac
ECONOMIC CALCULATION OF TRANSPLANTS 'HEALTH EXPENDITURE
In recent years, a number of studies have been published on the economic evaluation of transplantation of solid human organs. It is generally assumed that it is largely incomplete or thorough, which would contribute to improving the way for stable transplantation economic evaluation. The cost of kidney and liver is largely overlooked. However, this is not a conclusion when it comes to lung, heart, thin intestine, or pancreas, given many influencing factors such as screening criteria, long chronological follow-up of results, or the way of estimating a variety of cost and other variables.
Due to the inevitable dialysis, the Tx kidney is cost-effective and brings undue savings. Tx liver also brings savings. But when it comes to other bodies, this can not be categorically defined.
Answer dr.Marina,
DISSERTATION EXPERIENCES IN THE WORLD
Prices for transplanting vary between countries, and change over time. It is difficult to compare the effects for individual countries, especially among those who have only public health with those who have combined private and public health.
Organ transplant prices have fallen in recent years due to strong medical and technological advances. Cost-effectiveness of kidney transplantation, given the high dialysis price, is unquestionable. The kidney transplant releases great financial savings that flow again into a never-richly rich health system for other needs.
In 2010, approximately 4 billion euros spent in the EU for treatment of terminal kidney disease. This involves transplantation and post-transplantation treatment.
In France, for example, in 2010 there were about 40,000 patients with terminal renal disease. The cost of dialysis per patient amounted to about 65,000 euros a year. Tx stood around 55,000 euros. Immunosuppressive treatment costs 8,000 euros. In conclusion, the kidney transplant for a period of ten years saves the health care system almost 600,000 euros. Of course, this should improve the quality of life of the recipient, which makes it possible for his greater economic contribution. These findings, besides the others, launched a public action named Demain, la Greffe (transplantation in the future), to increase the number of collected and transplanted organs. Taking into account the savings that transplantation brings, we can assume what this represents for the health system.
In the United States, approximately 600,000 terminal kidney patients are transplants annually by only 3%. The annual dialysis cost is about $ 50,000. The cost of kidney transplantation is close to $ 100,000, with costs in the first year. In the second year, all costs for the recipient amount to about $ 20,000, and from the third year onwards, the health care system achieves significant savings. The Maryland US study states that the costs of transplantation have been reduced so that they cover after 2.8 years of treatment for patients previously in regular dialysis. For transplanted patients who do not need additional hospitalization, cost effectiveness is achieved after 1.8 years.
In the United Kingdom, there were 21,000 patients on dialysis in 2010. The dialysis price was 35 000 pounds a year. In this country, a total of 500million pounds, or 3% of total health care, is spent on dialysis. The cost of transplantation is 17,000 pounds, with about 500 pounds per year for immunosuppression. The transplanted kidney will save about 25,000 pounds for each subsequent year. In this country, 23,000 transplanted patients with functional kidney have protected the health system by about 215million pounds for dialysis.
I
Answer dr.Marina
DISSERTATION EXPERIENCES IN THE WORLD
In Spain, kidney transplants annually spend around 60m euros. The cost savings for one transplant patient are 21 000 euros. This brings the health system total savings of 46m euros. This covers the costs of transplanting all other solid organs
In Canada, the cost of dialysis per patient is approximately $ 60,000 a year. Transplant. The kidney cost about $ 25,000, and the immunosuppression of an additional $ 5,000 a year. So, in the first year there is no economic effect, but in the second year it's about $ 50,000. And so yearly for the entire life of the transplanted organ. So, the savings amount to $ 250,000 for the next five years of life of the transplanted kidney.
Such calculations should add indirect effects to the overall economy. Such savings can not be achieved in any other healthcare area.
Conclusion
Transplant kidney cancer provides proven economic and financial benefits. Whether kidney is obtained from a live or dead donor, transplantation is the most affordable solution for the health system and the best option for the patient's health and quality of life!
sources:
• Nordic Journal of Health Economics
• Transplantation Proceedings
• Maryland's tx feasibility study
• Personal information
• European Commission: Economic costs and benefits of transplantation
• The Economics of Kidney Failure, The Kidney Foundation of Canada
Regardless quality of life, is the treatment of given diseases more cost effective than transplantation?
Answer dr.Nejra!
FINANCIAL ASPECTS OF ORGAN TRANSPLANTATION
FINANCIAL ASPECTS IN ORGAN TRANSPLANTATION
Ognjen RIĐIĆ, Goran RIĐIĆ, Zlatko ADEMOVIĆ,
Jasenko KARAMEHIĆ
Content
1. Introduction 413
1.1. Medicare (USA) 413
1.2. Medicaid. (USA) 415
1.3. Commercial or individual insurance 417
1.4. Types of Care Management Organizations 418
1.5. Living Donors 421
1.6. Posttransplantation Care 422
1.7. Immunosuppressant Coverage 423
1.8. Other Drug Remedies 425
1.9. Insured, uninsured and poorly secured patients 425
1.10. Health Care Costs in the United States 426
1.10.1. Latest Trends 426
1.10.2. Future Economic Trends and Possible Solutions 428
2. Data on kidney transplantation in Slovenia after
Access to Eurotransplant (ET) 430
2.1. methods 430
2.2. Results 430
3. Review the number of transplants in the FBiH for the period
2004 - 2008 430
4. Exercised drugs (immunosuppressive) in the period
2004th to 2008th 435 years
5. Review of the number of patients treated with immunosuppressants and
Average Factor Immunosuppressant Consumption per FBiH patient
Period 2004-2008 2008 438
6. Review the number of patients, number of dialysis and total costs
Hemodialysis in the period 2004-2008 442
7. Overview of dialysis dialysis costs per dialysis
Patient in the period 2004-2008 2008 447
8. Literature 453
INTRODUCTION
1. INTRODUCTION
1. INTRODUCTION
1. INTRODUCTION
The progress of surgical techniques, immunosuppressive agents and the spread of a living and cadaveric donor pool have made the transplantation a very important option for an increasing number of patients. Patients who are considering transplantation will have several educational needs and many issues. Funding of transplantation is likely to be among the major issues that will have to be answered before referring the patient to the transplant.
According to Haubold (1999), average fees for kidney and liver transplantation as well as other organs have decreased in recent years. The main reason for reducing costs is primarily to shorten the period of stay in the hospital. Other reasons for reducing the cost are: (pressure from taxpayers and the availability of new, effective immunosuppressive agents).
The cost estimate included costs for the evaluation of transplantation, maintenance of candidacy, purchase costs for living and cadaveric donors, all hospital and medical expenses, post-transplant care, and immunosuppressive medications for the first year.!
What is your opinion regarding cost-benefit in the area of organ transplantation in Bosnia-Herzegovina and the world ?
1.7. Immunosuppressant coverage
drug ........................................
Although research on finding ways to prevent transplant rejection is underway, almost all transplanted patients are currently on immunosuppressive medicines and will need to do this throughout their lifetime of transplantation. Medicare provides 80% coverage for immunosuppressive agents, and over time the coverage (11) has increased. In 2000, the Welfare and Protection Act (BIPA) was adopted. This supplement extended the lifespan of immunosuppressive coverage to some organ recipients by reverting coverage to some who lost that right. However, this lifetime coverage does not extend to all recipients covered by Medicare insurance (11). -----------------
Thomas (2001) defined those covered and the duration of their coverage:
* ESRD-Medicare users are covered after successful kidney or pancreas transplantation over a 36-month period. If this was the only condition of the patient on Medicare coverage, Medicare benefits, including immunosuppressive coverage, will cease after 36 months.
Social Security Disability Insurance (SSDI) and Medicare users will continue to have immunosuppressive remedies as long as they meet SSDI requirements and have met a 2-year standstill period for gaining rights. A patient who loses the right to immunosuppression during a waiting period will have recovered coverage when he or she is eligible for insurance. ----------------
Social Security Retirement Employees (SSRs) are entitled to Medicare due to age and have the right to immunosuppressive coverage. If this right is lost, it will be re-established when the user reaches 65 years of age.
Receivers of another body have the right to compensation for costs if they have accepted Medicare because of SSDI or SSR and their organ transplantation was paid by Medicare. ----------------------------------
Coverage for immunosuppressive medicines for transplant recipients with Medicaid may be different from country to country. Patients should consult their individual state agency for coverage conditions. More than 92% of people who are members of management plans have coverage and medication. This is an addition to almost all insurance (12). Costs of medication are quite high, and MCO are forced to introduce strategies that have helped keep costs down. These include the use of Goodwill Drug Management (PBM), the introduction of a form, a supplement to paying the patient, and limitations on the amount of medication the prescription has been filled (12).
PBMs are specialized companies that provide services at several pharmacies. MCO contracts with PBM eliminate the need for internal pharmacies, and PBMs can usually provide more cost-effective services (12). Some PBMs require that all but the first receptacle be filled in by Mail Order, while others offer an option or Local Pharmacies In Network or Mail Order.
Customers often pay higher contributions for the convenience of filling in a local apothecary. Many MCOs have launched systems of contribution rows where generic medicines carry a minimum payment surcharge. There are several rows for new Brand Name Drugs where the cost of paying medicines is higher if the drug is not a preferred intake of MCO (12). -------------------------------------------
Most MCOs have their own formulas. In some organizations, only the medicines in the form are available to users. Other MCOs have proprietary medicine formulas and "management approaches" to other medicines that require pre-certification and medical justification for them. Forms are not arbitrarily selected. They are usually constructed using treatment guidelines derived from medical specialties or government agencies (12). Provider usually has the option of seeking an exemption if the medical necessity for a particular pharmaceutical agent can not be demonstrated!
1.8. Other medication issues
Receivers of transplanted organs usually need prescribed medicines for other diseases such as hypertension or diabetes. Medicare, as previously explained, covers only 80% of immunosuppressive medicines. Medicaid and commercial drug plans usually do not cover medicines that can be purchased in a pharmacy and these plans once provide the ultimate coverage coverage on a calendar or annual contract. In these situations, the patient will require instructions or, possibly, assistance to investigate the medicines offered by state agencies. Drug manufacturers can offer help programs in which patients, if they qualify, can actually receive free shipping or reduced medicines directly from a pharmaceutical company or vouchers will be sent for obtaining prescribed medicines from a local pharmacy. Nephrology nurses can teach the patient to seek help from a social worker or a financial or clinical coordinator of a dance center to investigate these options.
2. ABOUT TRANSPLANTATION OF BUBBLES IN SLOVENIA
AFTER ACCESS TO EUROTRANSPLANT (ET).
2.1. methods
Slovenia (population: 2 million) has one kidney transplantation center. The establishment of an appropriate national transplant organization resulted in an increase in the number of transplants and acceptance in Slovenia ET at the beginning of 2000.
2.2. Results
By the end of 2004, 607 kidney transplants were performed. From 1970 to 1998, 124 patients were allowed to live a kidney donor largely from the family (15). From 1986 to 1999, 239 patients received kidney graft from deceased donors. From 2000 to 2004, 244 patients were transplanted from deceased donors. In 2004, 55 kidney transplants were performed. One hundred and forty-one (57.8%) were renal grafts supplied from other Eurotransplant sites. HLA antigen disagreement of 2.8 ± 1.1 is not significantly different from that of 2000. By December 31, 2004, the patient's survival rate was 98.3% and 96.0%, respectively. Concomitant graft survival rates were 95.8% and 93.5% (16). At the time of ET, the number of premature kidney donors per year was 2.8 times higher than that of 14 years ago. In 2004, the average number of deceased kidney transplant donors per million population of ET was reached. Tissue compatibility with these recipients is not significantly better than before the ET era. Short-term and medium-long results in the ET era were completely comparable to those in large reports (17.18). --.
Data on dialysis services in the Federation of Bosnia and Herzegovina
In accordance with the Health Care Program funded by the funds of the federal solidarity fund provided to persons with terminal stage of renal insufficiency, the services of chronic and acute hemodialysis and peritonal dialysis are provided.
Funds from the Federal Solidarity Fund are funded as follows:
- purchase of supplies for chronic and acute hemodialysis or peritoneal dialysis and
- purchase of medicines for chronic and acute hemodialysis or peritoneal dialysis.
Within the dialysis program, the following costs are co-financed by the funds of the federal Solidarity Fund:
- provision of chronic and acute dialysis services (medical team work costs, in accordance with standards and health care standards);
- hot meal for patients during treatment of chronic hemodialysis, at a fixed price per meal / patient;
- transport of patients to chronic hemodialysis according to the prices determined by the number of kilometers traveled.
Hemodialysis funds spent in the Federation of BiH
From the data presented in table 5 regarding dialysis costs (KM) in health institutions in the Federation of Bosnia and Herzegovina in the period 2003 to 2011, it is noticed that total funds spent on dialysis from the funds of the federal solidarity fund have been growing steadily since 2003 , When they amounted to about KM 17.8 million, to about KM 31.9 million in 2011. These amounts include all costs foreseen by the program funded from the funds of the federal solidarity fund, not the cost of transporting patients to dialysis.
Dialysis costs trends, expressed in KM, in the health facilities that provide this type of services on the territory of the Federation of Bosnia and Herzegovina during the period 2003-2007 are also presented in Graph 6.
From these data it can be registered that in the majority of dialysis centers, in the observed period, the costs permanently increased. Certain exemptions represent a dialysis center (DC) in UKC Tuzla, where costs are in 2011. Were slightly lower than a year earlier, as did DC in Mostar, dialysis costs have started to decline since 2009, Table 5.
In DCs in KB Livno and OB Tešanj these costs were relatively constant in the observed period
. LITERATURE:
1. Eurotransplat International Foundation, Anual Report, 2010 / ed. By Arie Oosterlee and Axel Rahmel, Den Haag, 2011
2. Aljosa Kandus, Miha Arnold and Andrej F. Bren Apheresis and Dialysis: Official Journal of International Society for Apheresis, Japanese Society for Dialysis Therapy (2009), 13 (4): 264 -267
3. Ojo AO; Hanson JA, Meier-Kriesche H-U et al. Survival in recipients of marginal cadaveric donor kidneys compared with other recipients and waiting-listed transplant candidates. J Am Soc Nephrol 2001; 12: 589-597
4. Goodman WG, Danovitch GM, ed. Handbook of Kidney Transplantation, 4th edition. Lippincott Williams & Wilkins, Philadelphia: 2005; 1-22
5. Data from the Health Insurance and Reinsurance Institute of the Federation of Bosnia and Herzegovina
6. Federal Ministry of Health. The Law on Health Care. Federation BiH Official Gazette no.29 / 09. Sarajevo: Federal Ministry of Health, Sarajevo, 2009
What is the cost-effectiveness of organ donation? How can we evaluate investment into donor action and other donor initiatives?
Thank you for this very important question, because donors are the key as a resource for the onset of organ transplantation!
This is a very important issue in the segment of organ transplants without whom it can not be!
You need to constantly develop, affirm and attract new potential donors, organs!
It can only be done with the help and engagement of the wider social community and non-governmental non-profit organizations! An individual can do very little to do, but a set of individuals from different fields of work and life can do a lot to make affirmation and gain new donors and develop a donor network!
Selling references where you can find, potential answers to your question, are singular given because it is very important references - mostly large textbooks - books that have corresponding chapters that directly refer to your question and which carry great memory!
Regards
Transplantation of Kidney
author Jasenko Karamehic and contributing authors
Chapter VII -Living and Cadaveric Kidney Donation
Issue 2004 , Grafo Art , Sarajevo
Clinical Immunology -Book
authors :Jasenko Karamehic, Zehra Dizdarevic
Chapter 31- Living and Cadaveric Organ Donation author Jasenko Karamehic
Issued 2007 Svjetlost , Sarajevo
What is the cost benefit of organ transplantation?. Available from: https://www.researchgate.net/post/What_is_the_cost_benefit_of_organ_transplantation2#590c3ea2cbd5c2f4673365de [accessed May 5, 2017].
Transplantation Kidney and Pancreas Clinical Immunology Aspects and Pharmacotherapy author Jasenko Karamehic and contributing authors.
Chapter V- Living Donor Transplantation authors Sebija Izetbegovic,Jasenko Karamehic
Issue 2012 Svjetlost , Sarajevo
Transplantation Kidney and Pancreas Clinical Immunology Aspects and Pharmacotherapy author Jasenko Karamehic and contributing authors.
Chapter authors Economic Analysis of costs in Transplantation of Organs in Federation Entity of Bosnia and Hercegovina authors Slipičevic O. Jasenko Karamehic, Ridic o. Jukic T.
Issue 2012 Svjetlost , Sarajevo
What is the cost benefit of organ transplantation?. Available from: https://www.researchgate.net/post/What_is_the_cost_benefit_of_organ_transplantation2 [accessed May 5, 2017].
Transplant Immunology - Book
Author Jasenko Karamehic and contributing authors
Chapter 12.-Financial Aspects in organ Transplantation Author Ognjen Riđic and Jasenko Karamehic andcontributing authors.
Issue 2010 , Grafo Art, Sarajevo
What is the cost benefit of organ transplantation?. Available from: https://www.researchgate.net/post/What_is_the_cost_benefit_of_organ_transplantation2#590c44d9b0366d16bd64e449 [accessed May 5, 2017].
Immunosuppressive Therapy and use in Transplants Organs-Book
Authors -Jasenko Karamehic and Sebija Izetbegovic
Chapter 12- Financial Aspects of immunosuppressive Therapy O.Ridic,T. Jukic , J.Karamehic
Issue, Svjetlost Sarajevo 2012
Oni su briga svih nas: Donorska mreža u Kantonu Sarajevo 2007 – 2008
Dubravka Vokić, Faris Gavrankapetanović, Jasenko Karamehić, [...], Svetlana Broz
Book Oni su briga svih nas: Donorska mreža u Kantonu Sarajevo 2007 – 2008
Donorska mreža Kantona Sarajevo
www.donorskamreza.com/ - Prevedi ovu stranicu
Opis za ovaj rezultat nije dostupan zbog datoteke robots.txt web-lokacije.
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TUZLARIJE - Sve o doniranju i donorskoj mreži Donorska mreža ...
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Dr.Delic I think I have given very opaque and documented answers to this Your question!
Thanks for your cooperation!
One sentence organic transplantation if successful there is a huge benefit, especially for patients with transplanted kidney and pancreas, because it is cheaper than treating the underlying disease and all possible complications, as a result of terminal failure of these organs!
And the quality of life of patients who have received successful pancreas and kidney not to speak, because they no longer have to go on dialysis or receive insulin!
I think transplatation is most cost effectiv kidney and pankreas together at diabetes type 1!
Why?
One sentence organic transplantation if successful there is a huge benefit, especially for patients with transplanted kidney and pancreas, because it is cheaper than treating the underlying disease and all possible complications, as a result of terminal failure of these organs!
What is the cost benefit of organ transplantation?. Available from: https://www.researchgate.net/post/What_is_the_cost_benefit_of_organ_transplantation2#view=5927da4f615e27ede707ecca [accessed May 26, 2017].
Dear Prof. Karamehic ? What are in your opinion the most prevalent reasons for the academic community and patients to lobby against the organ transplantation ?
There's no logical reason for the academic community to lobby with patients against organic transplantation ! It can and should be just the other way around to lobby for organ transplants, to the postulates of science called organ transplants!
Ethical principles in organ transplantation
Today's science rightly enters the era of biotechnology and genetic engineering. What was until recently were mere science fiction, today is a reality. One of the aspects of this new reality is the fact that human tissue can be used in different ways. For many of these uses benefit is questionable and set new ethical dilemmas.
The fundamental ethical issues are:
1. Is some of the use of human tissue is unacceptable even when they are enacting agree to use this tissue?
2. What are the procedures to preserve the credibility of obtaining consent?
3. What are the pedestrian traffic bearing guidance for people who can not give consent because they are too young, too sick or too old or too upset?
4. Should the human tissue considered personal property?
5. Under what conditions might be, if at all, and could, human tissue is considered the property in terms of equity requirements, whether they can truly set this request?
6. Is there a circumstance under which it can allow the commercialization of human tissue?
Clarification of any regulatory framework for use of human tissue must be based on appropriate ethical principles that are discussed in this chapter.
Which features make their use acceptable human tissue? It is obvious that some use is not ethically acceptable: cannibalism or products of human skin or the production of soap they use that are obviously unjust, without further ethical arguments. The others use more complex for consideration. Is it justified to sell or buy human tissue? Are they from whom tissue taken have the right to say or connection with the further use of this tissue?
Philosophers find it difficult to solve this issue. Some consequentialists as John Harris advocate commercialization of human body parts while others like R.E.Goodina the opponents of same. Some advocates of human rights, particularly in the United States claim that the rights of individuals over all parts of the body including the right to their sale and control future use. Another particularly in Europe claim that human rights are better respected if they are based on nekomerijalnom form of organization.
. Ethical criteria in organ transplantation
Numerous problems of medical ethics are linked to the heavy or dying (terminal) of the patient, and often with the problem was identified and evoked entire medical ethics. Transplantation thanks to scientific research, technological, information and communication and organizational progress is becoming more affordable method of treatment. However, despite the fact there is still a big difference in the number of patients on the waiting list for an organ transplant and committed and the number of cadaveric donors. That number is growing from year to year, but he is not around does not meet the need for organs even in countries with the most developed organization of the collection and transplantation of organs.
This difference can be reduced in various ways, but without doubt the most important detection, and selection and evaluation of potential donors, and foundations and organizing donor network. It is difficult but necessary to get to the body and not just the living donor - close relatives, but also the dead person. It is necessary therefore, organized the so-called access. cadaveric organ collection which is not only a natural way but it may reach a sufficient number of organs that can cover the growing needs.
According to general experience no successful organ donation no action in public. The collection of organs from deceased persons requires the active involvement of the public and the legal-legal regulations odnosnosno rationally organized and functionally bound donor network at the national level or in the region and beyond. This is the only area of medical science and practice, which can not exist without the support of citizens and society.
Donor card was created as a means to chat, challenge to think, create bet in communities of people, mainly families. Finally, the written and electronic media have shown recently that they are aware of the essence of the problem, that in this field have become aware of its high public accountability and that valuable examples saved many human lives, encourage donation and organ transplantation treatment. Since the media is expected to encourage the public to support everything that is necessary to transplant treatment in this country is progressing. Collective approach speaks of moral obligation to help others as long as it does not harm the one who gives. And in the religious sense, there is an obligation to help others. Ethnicity transplantation, and arbitrary ananimna donation, are the basis of organ donation. The organ donation is worth betting on solidarity and reciprocity, and subject to the principle of asymmetrical relations in terms of "solidarity among strangers."
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