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The cost of U.S. transplants for lungs and other organs might be rising much faster than the cost of U.S. kidney transplants, according to a new report from Milliman.
The estimated full price for a double lung transplant for a patient under 65 increased 81% between 2020 and this year to $2.3 million, the consulting firm found.
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For kidney transplants, the estimated bill charges increased just 1%, to $446,800.
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The cost of all types of single-organ transplants, tissue transplants and multi-organ transplants that Milliman analysts analyzed amounted to $14.43 per member per month for a health plan enrollee under 65, up 29% from the 2020 total.
The compound annual increase over that period was 5.2%.
Employers now spend an average of about $600 per member per month on health care. Milliman's estimate of the full billed price for transplants amounts to about 2.5% of the cost of care.
Milliman analysts based the figures for people under 65 mainly on data from the firm's Milliman Consolidated Health Care Cost Guidelines. Guidelines users can break out separate claims data for patients using individual coverage, fully insured employer plan coverage and self-insured employer plan coverage, but the new transplant cost report combines the data for patients under 65 with all different types of coverage.
The cost estimates reflect what hospitals and other providers bill for transplant-related products and services from 30 days before the transplant to 180 days after discharge.
The numbers exclude the effects of provider network pricing arrangements and other negotiated reimbursement arrangements.
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Allison Bell
Allison Bell, a senior reporter at ThinkAdvisor and BenefitsPRO, previously was an associate editor at National Underwriter Life & Health. She has a bachelor's degree in economics from Washington University in St. Louis and a master's degree in journalism from the Medill School of Journalism at Northwestern University. She can be reached through X at @Think_Allison.
