Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices

Senanayake, Sameera; Graves, Nicholas; Healy, Helen; Baboolal, Keshwar; Barnett, Adrian; Sypek, Matthew P.; Kularatna, Sanjeewa

doi:10.1186/s12913-020-05736-y

BMC Health Services Research

Table 2 Parameter estimates used in the model

From: Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices

Parameter	Current practice		Option 1		Option 2		Option 3		Option 4		Distribution	Level of evidence
Parameter	Baseline estimate	SEM	Baseline estimate	SEM	Baseline estimate	SEM	Baseline estimate	SEM	Baseline estimate	SEM	Distribution	Level of evidence
Transition probabilities
Probability of transplant while on waitlist												1
Lambda (λ)	0.2898	0.0184	0.2194	0.0225	0.3148	0.0222	0.3102	0.0292	0.3387	0.0243	Normal
Gamma (ϒ)	1.544	0.0188	1.609	0.0237	1.481	0.0217	1.5982	0.0235	1.490	0.0227	Normal
Age coefficient	−0.009	0.0011	−0.006	0.0017	−0.008	0.0013	−0.011	0.0016	−0.010	0.0014	Normal
Graft failure												1
Lambda (λ)	0.1662	0.0199	0.2018	0.0359	0.1307	0.0187	0.1219	0.0232	0.1173	0.0179	Normal
Gamma (ϒ)	0.4424	0.0158	0.4178	0.0180	0.4898	0.0212	0.4081	0.0185	0.4536	0.0204	Normal
Age coefficient	0.020	0.0025	−0.021	0.0034	−0.019	0.0031	−0.013	0.0036	− 0.015	0.0033	Normal
Mortality after transplant												1
Lambda (λ)	0.0020	0.0004	0.0023	0.0007	0.0022	0.0006	0.0021	0.0006	0.0018	0.0005	Normal
Gamma (ϒ)	0.9348	0.0313	0.9410	0.0353	0.8720	0.0396	0.9407	0.0357	0.8841	0.0392	Normal
Age coefficient	0.0475	0.0036	0.0465	0.0046	0.0457	0.0046	0.0479	0.0046	0.0521	0.0046	Normal
Mortality while on waitlist^#
Base case analysis	0.0184		0.0184		0.0184		0.0184		0.0184			1
Sensitivity analysis	0.0184	0.0003	0.0184	0.0003	0.0184	0.0003	0.0184	0.0003	0.0184	0.0003	Beta	1
Mortality after graft failure^#
Base case analysis	0.1091		0.1091		0.1091		0.1091		0.1091			1
Sensitivity analysis	0.1091	0.0006	0.1091	0.0006	0.1091	0.0006	0.1091	0.0006	0.1091	0.0006	Beta	1
Utility
Transplant	0.82; 95% CI (0.74–0.90)										Uniform	2
Dialysis	0.70; 95% CI (0.62–0.78)										Uniform	2
Cost (in AUD)
Transplant (1st year)	99,968 (+/− 15%)										Uniform	1
Transplant (2nd year onwards)	13,916 (+/− 15%)										Uniform	1
Dialysis	81,689.34 (+/− 15%)										Uniform	1

λ – Lambda (rate parameter); ϒ – Gamma (shape parameter); SEM Standard Error of Mean, CI Confidence Interval
Lambda, Gamma and Age coefficients were calculated from Weibull regression method. Fixed transition probabilities^# were calculated from cumulative incident rates as described in the methods section
Option 1: Best 20% of KDRI donor kidneys transplanted to best 20% of EPTS recipients. Remaining 80% of the donor kidneys transplanted to remaining 80% of recipients according the current allocation system; Option 2: Worst 20% of KDRI donor kidneys transplanted to worst 20% of EPTS recipients. Remaining 80% of the donor kidneys transplanted to remaining 80% of recipients according the current allocation system. Option 3: Youngest 25% of donor kidneys transplanted to youngest 25% of recipients. Remaining 75% of the donor kidneys transplanted to remaining 75% of recipients according the current allocation system. Option 4: Oldest 25% of donor kidneys transplanted to oldest 25% of recipients. Remaining 75% of the donor kidneys transplanted to remaining 75% of recipients according the current allocation system

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ISSN: 1472-6963

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