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Policies And Price Tags: The Public's Perception Of Face Transplants And Their Funding
Mya Abousy, BA, Hillary Jenny, MD, Helen Xun, BS, Nima Khavanin, MD, Francis Creighton, MD, Patrick Byrne, MBA, MD, Damon Cooney, MD, Richard Redett, MD, Robin Yang, DDS, MD.
Johns Hopkins University School of Medicine, Baltimore, MD, USA.

PURPOSE: Face transplants are becoming rapidly available across the United States, with more than forty cases since 2005. However, the issue of financial coverage for the procedure is unresolved: face transplants can cost over one million dollars, and are usually not covered by insurance companies. The financial burden of face transplants creates a major barrier, yet has not been formally studied. Furthermore, as face transplants become more reported in the media, the public's perceptions of face transplants and financial coverage is still not well understood. This study is the first to evaluate the layperson's opinions on face transplants and the associated financial responsibilities.
METHODS: 815 laypersons surveyed through Mechanical Turk were presented information explaining the face transplant procedure, immunosuppressive therapy, and risks. Respondents rated their agreement with 11 statements on a Likert scale from 1 to 5. Topics included support of insurance coverage, taxpayer funding of face transplants, likelihood of having the procedure and amount willing to pay, the inclusion of faces in organ donation registries, whether transplants improve quality of life and appearance, and the importance of face transplants. Respondent demographics were self-reported, and responses were analyzed using descriptive statistics, the Wilcoxon Signed-Rank test, Chi Square test, and the Kruskal-Wallis test.
RESULTS: Respondents were supportive of face transplants in nearly all statements (10/11 items, p<.0001 for all). They would be willing to undergo face transplants if they suffered from face disfigurement; believed face transplants were as important as other organ transplants; believed faces should be included on the organ donation registry; supported insurance companies providing coverage for face transplants regardless of the cause of trauma; supported their tax dollars funding the procedure; and believed face transplants improved both physical appearance and quality of life. Although respondents generally supported their tax dollars funding the procedure, fewer supported this for self-inflicted trauma, with a roughly equal split between those who agreed and those who opposed in this case. The most common price range that respondents were willing to pay for a face transplant was $10,000-$99,000 (36.43%), and only 12.05% were willing to pay more than $500,000; yet only 5.68% of those willing to pay the latter reported an income greater than $150,000. Stratification by age or gender revealed that younger (age 18-24) respondents or males were more likely than older respondents (age 25+) or females to believe that face transplants are as important as other organ transplants (p<.001).
CONCLUSIONS: The financial aspects of face transplant are still being established. However, this study highlights that there is a significant disconnect between the public's opinions on face transplant coverage and the current lack of coverage in practice. Respondents not only support insurance coverage of face transplants, but also believe face transplants should be treated in a similar manner to other organ transplant procedures. Respondents' acceptance of including faces on organ donation registries could potentially eliminate the significant issue of locating a donor, and increasing financial coverage of this procedure may broaden its accessibility to a wider range of individuals.


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