The Cost of Heart Transplant in Iran: A Multicenter Analysis

Abstract

Abstract

Background

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.

Methods

This study was conducted in two phases. First of all, 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 2014 to May 2016. Then pre-transplantation, transplantation and one-year post-transplant cost were calculated according to the ABC (activity-based costing) method in 2017.

Results

Data were obtained for 120 patients which 95 (79.17%) were males with mean age of 35.31 ± 13.41. Mean hospital and ICU length of stay were 17.85 ± 14.91 and 9.74 ± 8.94 days, respectively.

A significant correlation existed between 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 2014 to 2016. Using the ABC costing method, the cost of pre-transplantation, transplantation and one-year post transplantation were extracted 6.5%, 73.5% and 20%, respectively, with the 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, heart transplantation surgery is performed in university-based hospitals and supported by the government. On the other hand, a significant difference exists between personnel costs in Iran compared to other countries.