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Sicker Patients With End‐Stage Liver Disease Cost More: A Quick Fix?

A growing population with end-stage liver disease (ESLD) and access to novel therapies including liver transplantation (LT) has led to a mismatch between availability of suitable organs for transplant and a rising demand. The Model for End-Stage Liver Disease (MELD) has favorably impacted sicker patients with ESLD through earlier access to LT with resulting increased net benefit from transplant. Not surprisingly, care for ESLD patients with higher MELD scores is more costly than for those with lower MELD (1). Furthermore, allocating organs to higher MELD patients has raised the cost of LT. However, the impact on cost of pretransplant care associated with more rapid access to LT through change in allocation policy has not been studied in a systematic fashion.