Cost-effectiveness of policies Aimed at Increasing Organ Donation, the Case of Chile

Background: In this paper we present an economic evaluation of policies aimed at increasing deceased organ donation in Chile, a developing country that has low donation rates; 5,4 donors per million people (pmp) in 2010. Methods: Expert opinion of leading participants in donation and transplantation were analyzed, resulting in a set of local policies aimed at increasing donation rates. Using previous results of reported cost savings of increasing kidney transplant in Chile, we estimate the net benefits of these policies, as a function of additional donors. Results: The main problem of the Chilean system seems to be the low capability to identify potential donors and a deficit in Intensive Care Unit (ICU) beds. Among considered policies central to increase donation are: an increase in human and capital resources dedicated to identifying potential donors, providing ICU beds from private centres and the development of an online information system that facilitates procurement coordination and the evaluation of performance at each hospital. Our results show that there is a linear relation between cost savings and incremental donors pmp. For example, if these policies are capable of elevating donation rates in Chile by 6 donors pmp net estimated cost savings are approximately US$ 1.9 million. Likewise, considering the effect in patients’ quality of life, savings would amount to around 15.0, million dollars per year. Conclusions: Our estimates suggest that these policies have a large cost-saving potential. In fact, considering implementation costs, cost reduction is positiv0 after 4 additional donors pmp, and increasing afterwards