Economic evaluation of lung transplantation : exploring the balance between costs and health consequences

The main focus of this thesis was on the economic evaluation, which was part of the MTA of lung transplantation. In this economic evaluation, the costs and effects (= health consequences with regard to survival and quality of life) for patients enrolled in the Dutch lung transplantation programme were compared to the costs and effects in the situation without a programme. For such a comparison, in general a randomised clinical trial is considered as the most optimal study design. However, in view of the expected positive effects of lung transplantation on survival, it was considered unethical to perform a randomised clinical trial. Therefore, all suitable patients were admitte to the transplantation programnre. Consequently, only costs and effects with the programme were observed and costs and effects in the situation without the programme (in which patients receive a usual treatment for their lung disease until death) were estimated on the base of pre-transplantation evidence. Zie: Summary