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Examining Corneal Tissue Exportation Fee and Its Impact on Equitable Allocation
Heather Machin1,2, Gerard Sutton3,4, Paul N Baird2
1Lions Eye Donation Service, Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia.
Cornea
|September 6, 2021
Summary
Global corneal tissue export fees vary widely, from $100 to $6000, with no fixed structure. Allocation is inequitable, prioritizing importers who can afford higher prices, hindering access for many awaiting transplants.
Area of Science:
- Ophthalmology
- Transplantation Science
- Health Economics
Background:
- Corneal transplantation is a critical procedure for restoring vision.
- The global trade in human corneal tissue is complex and lacks standardized pricing.
- Equitable access to donor corneas is a significant challenge in ophthalmology.
Purpose of the Study:
- To investigate the factors influencing the pricing and allocation of exported corneal tissue.
- To understand the perspectives of eye tissue and eye bank professionals on corneal tissue trade.
- To identify barriers to equitable access in the global corneal tissue supply chain.
Main Methods:
- Grounded theory approach utilizing semistructured interviews.
- Purposive sampling until thematic saturation was achieved.
- Sentiment analysis to gauge participant opinions on pricing and allocation.
Main Results:
- Interviews with 92 global eye tissue and eye bank professionals revealed significant price variations for exported corneal tissue ($100-$6000 or gratis).
- No global fixed fee structures were identified; pricing is influenced by export and import factors.
- Corneal allocation is primarily based on the importer's ability to pay the price set by the exporting eye bank, leading to inequitable distribution.
Conclusions:
- The current fee-influenced allocation system for exported corneal tissue is inequitable, prioritizing those who can afford higher costs.
- Developing standardized fee structures is essential to promote equitable allocation of corneal tissue.
- Equitable access to corneal tissue is crucial for improving outcomes for patients awaiting transplantation and supporting global eye bank development.
