Is a paying kidney donors a fee for their organ donation a good idea? In a new study published online on October 24, 2013 in the Clinical Journal of the American Society of Nephrology, the authors argue that, yes, it is.
The authors contend that if kidney donors were paid a $10,000 fee, it would increase the number of organs available each year for donation by at least five percent, which would make transplants less expensive and more available than the current system.
Kidney transplants are the best treatment available for those with failing kidneys; but, there is a perpetual shortage of organs because it is difficult to find people who are willing and able to give their organs. In fact, the rates of donation have remained largely unchanged over the past decade.
Of course, the idea of paying people for their organs raises many questions, involving a range of moral and ethical issues; and, it is illegal in all countries except Iran.
In order to determine the financial feasibility of paying kidney donors, the authors of the study – Dr. Lianne Barnieh and a team of scientists from the University of Calgary in Calgary, Canada – studied whether a third-party or government program of paying donors $10,000 would be an economical way to raise the number of donations. In addition, they wanted to know if it would be beneficial to the patient.
According to their estimates, if the number of kidney donations rose by a conservative figure out five percent, it would cost $340 less to treat each patient than it currently does. This savings, which more than exceed the cost of paying the donor, would come from the fact that dialysis costs would be lower.
If the number of kidneys available for transplantation increased by 10 – or even 20 – percent, then the savings would rise even further, the authors said. With a 10 percent increase, the savings realized would be $1,640. And, with a 20 percent increase, the savings would be $4,030.
There would also be benefits for the patient, they said. With the more modest figure of a five percent gain in kidneys available, patients would have an increase of quality-adjusted life years of 0.11.
Quality-adjusted life year (QALY) calculations are a way of comparing two different medical treatments to see which has more value for the patient. They are arrived at by multiplying each year of life gained by a weighting factor reflecting the patient’s quality of life during that time. The weighting factor ranges from 0 (death) to 1 (perfect health).
When the researchers calculated QALYs for kidney donation increases of 10 and 20 percent, they found that they increased to 0.21 and 0.39 respectively.
In an editorial that was published with the article, University of Pennsylvania researchers Matthew Allen and Dr. Peter Reese propose a limited trial of such an incentive program, saying that the time is right to begin considering whether paying kidney donors is a good idea. They suggest that having more empirical evidence of its benefits could help reassure those who might feel that the practice is unethical.
Written by: Nancy Schimelpfening