The Cost of Heart Transplant in Iran: A Multicenter Analysis

• Published in: International journal of organ transplantation medicine Vol. 12; no. 3; pp. 23 - 29
• Main Authors: Ahmadi, Z H, Shafaghi, Sh, Mandegar, M H, Salehi, M, Sharif Kashani, B, Naghashzadeh, F, Jahangirifard, A, Bakhshandeh, A, Afshar, A, Kazempour, M, Sheikhan, F
• Format: Journal Article
• Language: English
• Published: Iran Shiraz University of Medical Sciences 01.01.2021
• Subjects: Activity based costing; Brain death; Costs; Cytomegalovirus; Drugs; Expenditures; Heart failure; Heart transplants; Hospitalization; Immunosuppressive agents; Length of stay; Males; Mortality; Patients; Surgery; Iran; United States > US; Heart failure; Activity-based costing; Heart surgery; Heart transplantation
• ISSN: 2008-6482; 2008-6490

Heart transplantation is an established treatment for end-stage heart failure patients, but its cost-effectiveness is under question. 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. 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. 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. 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.