Paying kidney donors would be cost-effective, study shows

Would you donate your kidney for $10,000? A new study from the University of Calgary in Canada shows that paying kidney donors would not only increase donation rates – but would be cost-effective as well.

Study author Lianne Barnieh, a post-doctoral fellow at the University of Calgary, has long been interested in exploring ways to increase rates of organ donation. Currently, people awaiting organs can receive them in one of two ways – from a deceased donor who provided consent while living or from a living volunteer. However, data from the Department of Health and Human Services has shown there are nearly 100,000 people in the United States currently in need of a kidney donation– and many will die waiting.

“We currently don’t have enough donors stepping forward, be it with deceased or living donation rates,” Barnieh said. “And the deceased donations, apart from improving the rate of consent, that’s a limited increase.”

Barnieh points out that the pool of kidneys donated from healthy, living people could potentially be much larger.

“Out of the living donor pool, people have two kidneys and we only need one to function, so that has the biggest potential to increase the donor pool,” Barnieh said. “We hypothesized that not everyone is motivated by the same things. Some are motivated by the act of volunteerism, but how can we get at another segment of the population that is currently not stepping forward?”

The researchers speculated that the best way to get more people to step forward might be with cold, hard cash – and they had evidence suggesting the same. In an earlier survey, Barnieh and her team asked people whether they would donate an organ to a close family member or friend for $10,000, and nearly 50 percent of the participants said yes.

However, due to the controversial nature of a pay-for-organs system, Barnieh and her team wanted to make sure that paying donors would actually be a cost-effective move.

“We wanted to take a step back and remove some of the heatedness around it – because there’s quite a bit of debate – and look at this on the evidence we currently have,” Barnieh said. “Because if it turned out to not be cost-effective, we could stop there and look at a different strategy.”

In a study published in the Clinical Journal of the American Society of Nephrology, Barnieh and her team devised a financial model based on previous research, factoring in a variety of costs in addition to factors like improved quality of life for transplant recipients. Based on earlier surveys, they estimated that paying donors had the potential to increase donation rates by 5 percent.

“We based it on the 50 percent who would step forward (for $10,000), and we said, ‘Let’s take 10 percent of that and make it a conservative estimate,’” Barnieh said.

Using this model, Barnieh and her team found that their pay-for-organs policy did, in fact, prove cost-effective, offering a savings of about $340 per patient while improving each patient’s overall health outcome.

“It means it’s not only cost-effective, but outcomes for patients are better,” Barnieh said.

Barnieh acknowledges that her findings need to be tested in a real world setting before they can be confirmed. And while there’s still a long way to go before a pay-for-organs system could be implemented in the U.S. or Canada, she hopes that her research will contribute to a more informed dialogue on the subject.

“I think it would be great if that could be considered as a next step. But before we get there we need to have more discussions on the ethical and legal challenges and make sure the public is behind this...”Barnieh said. “I hope this opens the discussion further.”