Using the Pharmacoepidemiology Approach to Evaluate the First-Year Posttransplantation Ambulatory Health Care Cost From the Longitudinal Health Insurance Database (2001 to 2006) in Taiwan

This research evaluated the total first-year posttransplantation ambulatory health care cost using a countrywide health claims database. We searched all health reimbursement claims of posttransplantation patients from 2001 to 2006 using the ICD-9-CM codes (V42.0, V42.1, V42.6, V42.7, V42.8) for kidney, heart, lung, liver, and other specified organ transplantations. We excluded patients undergoing transplantation surgery > 12 months before 2001 or with 12 months of follow-up ambulatory visits to calculate the first-year posttransplantation cost. Among them, the first-year posttransplantation drug costs and total health care costs of the kidney, heart, lung, liver, and other organ transplantations were (m NTs) 346,396.6 ± 170,806.9 and 404,241.9 ± 182,499.1, 242,878.5 ± 128,772.7 and 302,325 ± 129,609.9, 345,792 ± 185,940.8 and 387,840.5 ± 184,244.5, 404,441.8 ± 299,311.7 and 471,631.5 ± 306,936.3 and 40,718.2 ± 50,740.2 and 67,469.8 ± 70,765.7, respectively. Drug expenditures were ∼80% of the total health care cost except for the other specified organ transplant, i.e., bone marrow, wherein they were 60%. The mean differences between drug expenditures and total costs of various organ transplants were significant (P < .01; ANOVA). Despite the first-year health care cost a the posttransplantation patient being less than dialysis costs in Taiwan, most end-stage renal disease patients are still a waiting organ donation; therefore, some candidates are seeking a transplants outside Taiwan.