In Summary
  • Compared to dialysis, patients with chronic kidney disease who receive a transplant live significantly longer, have fewer complications and a better quality of life.
  • The rational approach is to ensure that payment policy at the national health insurer contributes to the preservation of functional kidney transplants through lifelong coverage of immunosuppressants.

In the past few years, the national health insurer has made significant progress in supporting patients with chronic kidney disease.

Through the National Hospital Insurance Fund (NHIF), kidney patients can now access life-sustaining dialysis and renal transplant care. The insurer covers the initial surgery.

Compared to dialysis, patients with chronic kidney disease who receive a transplant live significantly longer, have fewer complications and a better quality of life. Moreover, transplant reduces the cost of treatment in the long run.

However, these gains stand to be lost if the current NHIF policy fails to cater for crucial medicines required to keep the transplant viable.

ESSENTIAL DRUGS

These medicines, known as immunosuppressants, pacify the body’s immune system’s reaction to the new organ, reducing chances that it will be rejected.

The drugs are required for as long as the patient has the transplant, which is viable for an average of 12 years.

Immunosuppressant drugs are as essential to the life of transplant patients as engine oil is to the car.

Subsequently, transplant recipients who fail to adhere to the medications, for cost or other reasons, face a higher risk of kidney failure.

These drugs are expensive. At an estimated cost of Sh40,000 a month in public hospitals, even the average middle-class household with an average income of Sh100,000 would find it difficult to afford this long-term treatment.

SUSTAINABLE

With the initial cost of surgery trending between Sh700,000 and Sh1.5 million, obtaining a kidney transplant would be a catastrophic expenditure for most Kenyans.

Whereas there is an alternative in dialysis, this can only grant patients an extra five years of healthy life and does not come any cheaper either.

Consider a case of two hypothetical patients, Chebet and Akinyi, both 30, suffering from chronic kidney disease and undergoing treatment over a period of five years. Chebet undergoes dialysis while Akinyi gets a transplant.

At the prevailing market rates, our analyses demonstrate the costs of Akinyi’s renal transplant, including her medicines, are lower than Chebet’s dialysis over the first five years but the latter must also get a transplant at the end of it.

Compared to Akinyi, Chebet will also have to make at least two visits every week to the dialysis centre, taking time away from work and other meaningful life activities.

The case for transplant against dialysis is settled.

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