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Cost-Effectiveness and Budget Impact Analysis of Implementing a 'Soft Opt-Out' System for Kidney Donation in Australia

Author

Listed:
  • Sameera Senanayake

    (Queensland University of Technology (QUT))

  • Helen Healy

    (Royal Brisbane Hospital for Women
    University of Queensland)

  • Steven M. McPhail

    (Queensland University of Technology (QUT)
    Metro South Health)

  • Keshwar Baboolal

    (Royal Brisbane Hospital for Women
    University of Queensland)

  • Sanjeewa Kularatna

    (Queensland University of Technology (QUT))

Abstract

Introduction There is a severe shortage of donor organs globally. There is growing interest in understanding how a 'soft opt-out' organ donation system could help bridge the supply and demand gap for donor organs. This research aims to estimate the cost-effectiveness and budget impact of implementing a 'soft opt-out' organ donation system for kidney donation. Methods A decision-analytic model was developed to estimate the incremental costs from a health system’s perspective, quality-adjusted life-years (QALYs), and death averted of people who have kidney failure, comparing a ‘soft opt-out’ organ donation system to an 'opt-in' system. This study analysed three scenarios where the 'soft opt-out' system generated a 20%, 30%, and 40% increase in deceased organ donation rates over 20 years. A 5-year time horizon was adopted for the budget impact analysis. Results A 20% increase in organ donation rates could have a cost saving of 650 million Australian dollars (A$) and a 10,400-QALY gain. A 20% increase would avert more than 1500 deaths, while a 40% increase would avert 3200 deaths over a time horizon of 20 years. Over the first 5 years, a 20% increase would have a net saving of A$53 million, increasing to A$106 million if the donation rate increases by 40%. Conclusion A 'soft opt-out' organ donation system would return a cost saving for the healthcare system, a net gain in QALYs, and prevention of a significant number of deaths. Advantageous budgetary impact is important, but understanding the aversion for a ‘soft opt-out’ system in Australia is also important and remains a priority for further research.

Suggested Citation

  • Sameera Senanayake & Helen Healy & Steven M. McPhail & Keshwar Baboolal & Sanjeewa Kularatna, 2022. "Cost-Effectiveness and Budget Impact Analysis of Implementing a 'Soft Opt-Out' System for Kidney Donation in Australia," Applied Health Economics and Health Policy, Springer, vol. 20(5), pages 769-779, September.
    • Handle: RePEc:spr:aphecp:v:20:y:2022:i:5:d:10.1007_s40258-022-00747-8
    DOI: 10.1007/s40258-022-00747-8
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    References listed on IDEAS

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    1. Zeynep Burcu Ugur, 2015. "Does Presumed Consent Save Lives? Evidence from Europe," Health Economics, John Wiley & Sons, Ltd., vol. 24(12), pages 1560-1572, December.
    2. Sameera Senanayake & Nicholas Graves & Helen Healy & Keshwar Baboolal & Adrian Barnett & Sanjeewa Kularatna, 2021. "Time-to-event analysis in economic evaluations: a comparison of modelling methods to assess the cost-effectiveness of transplanting a marginal quality kidney," Health Economics Review, Springer, vol. 11(1), pages 1-12, December.
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