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The Cost of Heart Transplant in Iran: A Multicenter Analysis
Z H Ahmadi1, Sh Shafaghi1, M H Mandegar2
1Lung Transplantation Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Insights
Heart transplantation costs in Iran are significantly lower than in other countries due to government support and lower personnel expenses. This study assessed heart transplant costs in Iran to aid regional planning.
Area of Science:
- Cardiology
- Health Economics
- Public Health
Background:
- Heart transplantation is a vital treatment for end-stage heart failure.
- The cost-effectiveness of heart transplantation remains a significant concern globally.
- Developing countries require specific cost analyses for resource allocation.
Purpose of the Study:
- To evaluate the comprehensive cost of heart transplantation in Iran.
- To provide data for future healthcare planning in Asian developing nations.
- To establish a cost benchmark for heart transplantation in a regional context.
Main Methods:
- A retrospective, multicenter study analyzed hospital data from three Tehran heart transplant centers (April 2013 - May 2015).
- Activity-based costing (ABC) method was employed to calculate costs in 2016.
- Data included pre-transplantation, transplantation, and one-year post-transplant phases for 120 patients.
Main Results:
- The average heart transplant and hospitalization cost from 2013-2015 was $3445.47 USD.
- The total cost per patient, calculated via ABC, reached $26,232 USD.
- Transplantation surgery constituted the largest cost component (73.5%), followed by one-year post-transplant care (20%) and pre-transplant costs (6.5%).
Conclusions:
- Heart transplantation in Iran is considerably more affordable compared to international benchmarks.
- Government support for university-based transplant centers and lower personnel costs contribute to this economic advantage.
- The findings offer valuable insights for healthcare policy and economic planning in similar healthcare systems.
Background:
Heart transplantation is an established treatment for end-stage heart failure patients, but its cost-effectiveness is under question.
Objective:
This study aimed to assess the cost of heart transplantation in Iran as a developing country in Asia to contribute to future planning in the region.
Methods:
This study was conducted in two phases. First, in a retrospective multicenter study, hospital data of heart transplant and hospitalization of three active heart transplant centers in Tehran, Iran, were reviewed from April 2013 to May 2015. Then pre-transplantation, transplantation, and one-year posttransplant costs were calculated according to the ABC (activity-based costing) method in 2016.
Results:
Data were obtained for 120 patients, among which 95 (79.17%) were males with a mean (SD) age of 35.31±13.41 years. Mean (SD) hospital and ICU length of stay were 17.85±14.91 and 9.74±8.94 days, respectively. A significant correlation existed between the mean of hospital and ICU length of stay (P<0.001, r: 0.754). The mean heart transplant and hospitalization cost was 3445.47±1243.29 USD from 2013 to 2015. Using the activity-based costing method, the cost of pre-transplantation, transplantation, and one-year -post-transplantation were extracted 6.5%, 73.5%, and 20%, respectively, with a total cost of 26232 USD.
Conclusion:
Compared to other countries, the cost of heart transplantation in Iran is very low. Numerous reasons lead to this difference. Firstly, a heart transplantation surgery is performed in university-based hospitals and is supported by the government. On the other hand, a significant difference exists between personnel costs in Iran compared to other countries.
