SEKITA Yasuyoshi Tohoku University, Graduate School of Economics, Professor, 大学院・経済学研究科, 教授 (20107113)
HORIO Hiroyuki National Cardiovascular Center Research Institute, Dept.of Epidemiolog, Divison, 疫学部, 室長 (20157069)
小坂井 嘉夫 宝塚市立病院, 心臓血管外科, 診療部長
宮武 邦夫 国立循環器病センター研究所, 生理検査機能部, 部長
MIYATAKE Kunio National Cardiovascular Center Hospital, Dept of Laboratory of Physiological Dia
KOZAKAI Yoshio Takarazuka Municipal Hospital, Dept of Cardivascular Surgery, Director
|Budget Amount *help
¥6,400,000 (Direct Cost : ¥6,400,000)
Fiscal Year 1998 : ¥2,100,000 (Direct Cost : ¥2,100,000)
Fiscal Year 1997 : ¥4,300,000 (Direct Cost : ¥4,300,000)
It is important to consider economic problems of organ transplant in order to establish transplantation medicine, In the present study, we conducted the problems in which a cost-analysis and a cost-benefit analysis (CBA) of organ transplant, especially heart transplant were included. In the first place, the following calculation method was contrived as the cost-analysis (1) Calculation of costs of operations for transplantation and post-operative management as the direct cost of the transplant, (2) Calculation of costs of donor heart transportation and working costs of a organ transplant network system such as informaton system and personnel expenses as the indirect cost of the transplant. The cost of heart transplant is obtained as the sum of the direct and indirect costs. Next, the following method was contrived as the CBA.(1) The time of prolongation of life by the transplant is adopted as an index of the transplant effectiveness. (2) The quality adjusted years (QALY) is used as an
index of the transplant utility. (3) The transplant benefit is calculated depending upon QALY by using the Hoffman method which is usually used for compensation of traffic accident. Real benefit is obtained as the difference of the benefit and the cost of the heart transplant. By using the before-mentioned methods, the following trial calculation of the cost and benefit was conducted under several conditions.
(1) Transplant cost (normal cases) : (1) Direct costs : extraction of donor heart \ 2,300,000, operations for transplantation \ 2,940,000, admission to a hospital (2 months) \ 3,644,000, post-operative management (3 months - one year after transplantation), \ 4,060,000/year (on and after two years), (2) Indirect costs : transportation of donor heart \ 1,300,000, working costs of the organ transplant network system \ 1,200,000/1 transplant, (3) Cost of heart transplant \ 15,375,000.
(2) CBA : (1) Benefit : \ 88,827,200 (in case of a male and 50 years old salaried man under the condition of work ability coefficient : 0.8), (2) Real benefit : \ 6,462,200