Economic and Financial Issues in Pancreas Transplantation

Information on economic and financial data of pancreas transplantation in the United States is scarce and usually outdated by the time it is published. This applies to organ acquisition costs, transplant hospitalization costs, and follow-up costs. Data appears to be more transparent and forthcoming from CMS than from private health insurance providers. In general, the following conclusions can be drawn regarding the economic and financial aspects of pancreas transplantation: (1) organ acquisition costs are too high, a national database to compare rates between individual OPOs does not exist, and attempts to regulate organ acquisition costs have failed; (2) reimbursement for physician services, and to a lesser degree for hospital and clinic services, is too low; and (3) the decrease in pancreas transplant numbers from 2004 to 2015 can be explained, at least in part, by the fact that many pancreas transplant programs lost money, which created institutional disincentives and, in turn, resulted in a decrease in the number of pancreas transplants between 2004 and 2015 nationwide.