Cost Structures of US Organ Procurement Organizations

Area of Science:

• Health Economics
• Transplant Logistics
• Public Health Policy

Background:

• Organ procurement organizations (OPOs) manage deceased donor organ procurement in the US.
• OPOs operate as not-for-profit federal contractors with exclusive geographic territories.
• Understanding OPO operational costs is crucial for national organ donation analysis.

Purpose of the Study:

• To conduct a national analysis of organ procurement organization (OPO) costs.
• To investigate factors contributing to cost variations among OPOs.
• To assess the financial health and market dynamics of OPOs.

Main Methods:

• Utilized five years of data (2013-2017) from 51 of 58 OPOs, obtained via Freedom of Information Act (FOIA).
• Developed and applied a generalized 15-factor cost regression model.
• Validated selected cost measures against IRS forms.

Main Results:

• Deceased donor organ procurement is a $1 billion/year operation; over 60% of organ cost is overhead.
• OPOs average $2.3 million/year profit and $45 million/year in assets, growing at 9%/year.
• Highest-cost OPOs are smaller, import more kidneys, have higher labor and support personnel costs, and spend more on professional education.

Conclusions:

• OPO financial security and asset accumulation suggest finances do not drive organ shortages.
• High asset levels may deter new market entrants.
• Current allocation models may subsidize tissue procurement, and professional education spending does not decrease procurement costs.