Kidney Transplants Desperately Needed To Offset ‘Tsunami Of Demand’ For Dialysis - Major Report

A major independent report has exposed the millions being lost to the New Zealand health system each year due to the government failing to increase kidney transplant rates.

The newly released NZEIR report, commissioned by Kidney Health New Zealand (KHNZ) directly compares the health system cost for a patient receiving kidney dialysis as opposed to a transplant. The report calculated average savings over six years of nearly $400,000 for every patient on dialysis who receives a transplant. It shows that lifting the number of kidney transplants right now by a further 50 patients per annum year-on-year would save our health system $70 million over the next six years – with a side benefit of placing New Zealand in the top five countries in the world for the overall rate of kidney transplants. It states that opportunities like this for the government to invest money in a way that both improves patient outcomes and saves money are ‘rare’ and should be a national priority.

“The findings from this watershed report are a shock and reinforce the urgent need for the government to act now to implement its own 2017 National Deceased Organ Donation Strategy and overturn decades of underinvestment, treatment inequity and fragmented service delivery” says KHNZ General Manager Michael Campbell. “These figures finally expose the disappointing track record of successive governments in failing to adopt basic and easily-achievable measures to increase our transplant rates. It’s now absolutely clear this failure is costing the New Zealand taxpayer not just millions annually in lost health dollars but costing patients their lives as well, as hundreds languish needlessly, slowly deteriorating on dialysis”.

The new NZIER data shows 3,700 Kiwis received dialysis treatment in 2020 at an average cost of $115,000 per annum. The report dramatically predicts a ‘veritable tsunami of demand’ for dialysis treatment in the years ahead. Dialysis patient numbers have exploded by 24% in the past six years and are modelled to rise a further 30% in the coming decade, a reflection of exploding rates of Type 2 diabetes, particularly among Māori and Pasifika patients. It concludes that without action, the cost of dialysis in 2031/32 will be $150 million higher than it is now.

Currently 462 New Zealand patients are waiting for a transplant, with the NZIER estimating the cost of a kidney transplant at around $75,000. The report calculates that having a patient on dialysis for six years costs $626,000; if that same patient were given a transplant, the cost six years on would be $237,000 for both their procedure and post-transplant care. If a dialysis patient lives for 20 years, the cost to the health system is estimated to be $1,040,000 compared to $538,000 if that same patient received an immediate transplant. New Zealand’s three renal transplant units carried out 221 kidney transplants in 2019, or 45/per million, well behind countries like Spain with 74/per million or the UK with 55/per million.

The NZEIR report recommends the establishment of a National Renal Service within the future Health NZ framework. They say this new entity must be adequately funded to enable development of a meaningful strategy, to ensure strong leadership, better patient equity, integrated services, and an increase in the renal workforce.

“This NZIER report paints a picture of a New Zealand renal service unfairly constrained by chronic financial and workforce underinvestment, siloed funding arrangements, a lack of equity in treatment delivery particularly for Māori and Pasifika patients and a lack of joined-up thinking. The fragmented nature of the current health system means that nobody actually owns the problem, whereas a National Renal Service would” says Campbell.

On top of the NZIER report, a separate, second report carried out by KHNZ expresses major concerns the government’s been “asleep at the wheel” due to a four-year delay in rolling out its own organ donation strategy.

“Although parliament unanimously passed legislation to implement and fund all six priorities from its 2017 National Deceased Organ Donation Strategy, only one of the six has been actioned so far - the decision to give the New Zealand Blood Service the leadership role to implement the strategy. However, that transfer itself was underfunded, covering pretty much just salary costs, leaving zero money for improved ICU coordinator training, improving the national donor registry, or promoting national donor education and awareness.

“There is now a golden opportunity within the current health system review for the government to turn this ship around and finally deliver this country a renal and transplant service which is fit for purpose.”

Kidney Health New Zealand is today demanding immediate government action to ensure both the NZIER report, and the findings of its own internal report are followed.

“We do feel the government has been asleep at the wheel here. If they stay asleep and don’t wake up to roll out their 2017 strategy as promised, fund the Blood and Organ Service to do its job properly and recognise the millions of precious taxpayer dollars being needlessly lost by an underinvestment in transplant, then hundreds more patients will simply die waiting.”

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