Why we should have a paid market in kidney transplants


One of those little secrets (well know to us illuminati of course) is that Iran is the only country in the world where it is legal to pay donors for organs for transplant. Iran is also, not all that surprisingly, about the only country without a long waiting list for kidneys for transplantation. One point that I hadn't realised:

It is well documented that RRT is cost effective treatment as compared to dialysis. For example the UK national health system (NHS) data reveals that the average cost of dialysis is £30,800 per year while the cost of kidney transplantation is £17,000 following by a £5,000 annual spend on the drugs. That means over a period of 10 year (the median graft survival time: the time that transplanted kidney survives in patient’s body), the average benefit of kidney transplantation, comparing to dialysis, is £241,000 per patient (UK Transplant, 2007).

The payment to the donor amounts to roughly two years' minimum wages in Iran: some £24, £25,000 say here in the UK.

That there is no waiting list means that kidney disease sufferers are not wasting hours upon hours each week in dialysis: they are also much more likely to survive said kidney disease. Many here do die on the waiting list for an organ. But as you can see from the figures, one other thing a paid market is is cheap. Astonishingly so, for even if we include the payment to the donor (making the assumption that it would come from public funds), the saving over the 10 years is some 70% or so of the usual cost of treatment by dialysis. And yes, there are those who wait that long.

Even if we look at more realistic waiting times of a few years, it's still true that the transplant is cheaper than only 18 months of dialysis. Less death, better health and all for less money, what could possibly be wrong with this idea?

Well, other than the fact that the Great and the Good in our own dear Blighty seem infected with the idea that money, lucre, is just so icky and shouldn't be used to solve some problems.

Something of a pity for those who will die waiting on dialysis really as as the above shows, there really are some things which are too important for us not to use markets in.