The NHIF is seeking to develop a long-term plan that will promote kidney transplants as a viable alternative to dialysis.
When a kidney fails, a patient needs either of the two treatments to survive.
However, experts have argued that while dialysis performs only about 10 per cent of the work a functioning kidney does and its impact can cause other serious health problems and complications.
Kidney transplantation is the treatment of choice for End Stage Renal Disease.
This occurs when the gradual loss of kidney function reaches an advanced state making kidneys unable to work as they should to meet the body's needs.
The National Health Insurance Fund now seeks to come up with an incentive plan that will see patients get donations but without exposing the population to the risk of illegal organ harvesting and trafficking.
According to Health CAS Dr Rashid Aman, in the Financial Year 2020-21, NHIF spend Sh3.8 billion on renal dialysis, more than seven per cent of the total medical claims payout.
“The fund acknowledges that renal transplants are a better long-term plan in managing ESRD," Aman said.
"From projection estimates, a break-even is achieved at month 33 of dialysis assuming 100 per cent success rate with renal transplants."
The CAS in his report to the Senate Committee on Health dated June 2 noted that the enhanced cover entitles civil servants, government employees and retirees to additional benefits and saves money.
“The enhanced covers cost the government an additional Sh35,000 per year per employee for the enhancement, above the statutory contribution that is dependent on salary,” he said.
Ministry statistics show that at least 661 kidney transplants have been carried out in the country since 2006.
Some patients opt for dialysis instead of transplant because of the high cost of the life-long drugs needed after transplant.
NHIF pays Sh500,000 for a transplant but not for the life-long immunosuppressive drugs needed for the transplant.
A patient needs about Sh40,000 every month for the drugs to maintain that relationship without which the body often rejects the new kidney and the patient goes back to dialysis.
“The fund has developed a long-term plan to enable transition by incentivising transplants. These include a pharmacy benefits management concept in line with the GOK health products and technologies strategic plan 2020-25 to reduce the cost of post-transplant medication," he said.
Doctors said other potential donors are dropped because of their poor lifestyles which predispose them to chronic diseases like diabetes.
Kidney disease is projected to become the number five leading cause of premature deaths globally by the year 2040.
It is also estimated that almost 5,000,000 Kenyans are living with chronic kidney disease.
More than 12,000 people have ESRD requiring dialysis while currently, more than 5,000 patients are on dialysis in Kenya.
There are 214 dialysis units countrywide; 54 public health facilities, 143 private facilities and 17 faith-based.
Reports indicate that 70 to 75 per cent of kidney failure cases are due to uncontrolled high blood sugar and blood pressure.
High diabetes accounts for around 50 per cent of people and around 25 to 30 per cent is due to high blood pressure.
(Edited by Tabnacha O)
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