Study objectives: The influence of bronchiolitis
obliterans syndrome (BOS) on costs after lung transplantation was
investigated by comparing the costs of patients with and without this
Design: Follow-up costs were prospectively
investigated in a medical technology assessment of the Dutch Lung
Transplant Program, in relation to the development of the BOS. First,
average follow-up costs per week per patient were compared between
patients who did or did not develop BOS. Second, in the BOS group,
these costs were compared before and after the onset of BOS.
Setting: Dutch Lung Transplant Program, University
Hospital of Groningen.
Results: Data on 53 patients
(37 patients without BOS and 16 with BOS) who underwent transplantation
between November 1990 and April 1995 were available. The average
follow-up time of these 53 patients was 1.5 years. The follow-up costs
amounted to an average (in Dutch guilders [Dfl]) of 1,774/wk for
non-BOS patients, compared to 3,072/wk for BOS patients (+ 73%;
p = 0.002; one Dfl = 50 cents US currency). This difference in
costs was largely accounted for by an increase in used health-care
resources, in particular hospitalization and medication. For the BOS
patients, the average costs per week before and after the onset of BOS
were 1,941 Dfl and 2,422 Dfl, respectively.
Conclusion: BOS is associated with substantial extra costs.
These findings reemphasize the need to focus efforts on prevention of
BOS to enhance the cost-effectiveness of lung