THE POTENTIAL MARKET FOR KIDNEYS: EVIDENCE FROM GERMANY ON
PEOPLE’S WILLINGNESS TO BUY AND SELL ORGANS
Students in Germany are willing to sell a kidney if it can be used to save another
person’s life. And because their decision is not affected by their wealth, it would be
possible to set up market where people buy and sell kidneys without exploiting the
poorest. Doing so could save many thousands of lives.
That is the main finding of research by John Haisken-DeNew and Thu-Van Nguyen,
which asked 682 students from the Ruhr University Bochum in Germany whether they
would be willing to pay €20,000 for an immediate kidney transplant – if they needed
one tomorrow.
Students were also asked how long they would be willing to wait for the transplant if, for
each the months waited, the price fell by €1,000. Thus after five years, which is the
average waiting time for a kidney in Germany, the hypothetical €20,000 kidney would
be received without charge.
The study, presented at the Royal Economic Society’s 2011 annual conference, found
that:
 Around half of all respondents chose not to wait at all and to pay the full €20,000.
 Blood donors and wealthier students are more likely to be willing to pay for a
transplant rather than wait.
 On average, people chose a waiting time of two years at a price of €12,000.
 People with a history of personal illness or illness within the family were more
open to the idea of selling their kidney and would charge a much lower price,
€7,798.
 Blood donors and wealthier students were also more likely to sell a kidney and to
donate, with income proving irrelevant in the decision.
 The average price students would charge for their kidney was €21,681.
Given that more than half of respondents were willing to buy a kidney for €20,000, and
that the average selling price was €21,681, there would have been several potential
sales of kidneys once their compatibility had been ascertained. This study therefore
suggests that if it were made legal, a market for kidneys could exist in Germany, saving
many thousands of lives.
Several economists in the US have been arguing for the introduction of a market for
kidneys after the successful introduction of a donor market in New England where
people trade compatible kidneys.
More…
This study provides evidence that the willingness to pay for, as well as the willingness
to ‘sell’ an organ (a kidney in particular) exist, so that a controlled market for transplants
could be introduced, without facing the problem of exploitation of economically weaker
individuals.
It is found that the willingness to ‘sell’ one’s organ is independent of income: high
income earners have a 7 percentage point higher probability of ‘selling’ their organs
than low income earners. The willingness to donate itself is also not dependent on
income. Altruistic and empathy motivations seem to prevail.
A survey of 682 students from a university in a medium sized city in Germany was
conducted to find the determinants of the willingness to pay and the willingness to
donate.
On the demand side, people were asked whether they would be willing to pay €20,000
for a (hypothetically needed) immediate kidney transplant and how long they would be
willing to wait for the transplant, if it were linked to its price: for each three months
waited, the price would be reduced by €1,000.
The starting price is €20,000, meaning that after five years people would receive the
kidney without charge. This is relatively realistic as the average waiting times for
receiving a kidney transplant are about five years.
Blood donors have a 7 percentage point higher probability, high income earners
(€4,000 or more/month) have a 24 percentage point higher probability to be willing to
pay for a transplant, compared with those who have never donated blood and low
income earners respectively. On average, people would be willing to pay €9,890.
Approximately 50% of all respondents chose not to wait at all, and are willing to pay
€20,000 for an immediate transplant. On average, people chose a waiting time of two
years, which is equivalent to a willingness to pay of €12,000, whereas high income
earners would only wait slightly over a year. Obviously, this is much less than the
currently waiting time in Germany of five years.
On the supply side, people’s own experience with health emergencies within the family
lowers the barrier to donating. People who have been confronted with serious health
issues, such as having seen family members having had a hospital stay within the past
two years, are more able to relate to the necessity of organ donation. They have a 10
percentage point higher probability to ‘sell’ their organ, and would charge a much lower
price – a €7,798 lower price.
Blood donors have already made the first step into donating in general and are perhaps
more altruistically inclined, and have a 7 percentage point higher probability to donate a
kidney post mortem and a 13 percentage point higher probability to donate in vivo.
Furthermore, their probability to ‘sell’ their kidney is 7 percentage points higher.
High income earners have a 7 percentage point higher probability to donate a kidney in
return for payment.
The average price people would charge for their kidney amounts to €21,681, similar to
values actually observed in the United States. As for donating without financial
compensation, income does not have a statistically significant role.
All in all, the introduction of a controlled transplant market could potentially:
(a) reduce consumer surplus wastage, as the prior excess demand is reduced by new
donations;
(b) prevent overall medical deterioration of failed organ patients, as the waiting time
scheme is reduced on average from five to two years;
and (c) eliminate the worries of exploitation of economically weaker individuals as the
willingness to sell one’s kidney is not dependent on one’s own financial situation.
ENDS
‘Back to Life: The Potential Market for Kidney Transplants in Germany’ by Thu-Van
Nguyen and John Haisken-DeNew
Contact:
Thu-Van Nguyen
Email: thu-van.nguyen@rub.de
John Haisken-DeNew
Email: john.haisken-denew@rub.de