This study looked at how Nova Scotia’s Human Organ and Tissue Donation Act (HOTDA) could impact the health system financially, especially in relation to kidney transplants. It focused on whether the new opt-out approach—where people are automatically considered donors unless they say otherwise, offers better value for money compared to the old opt-in system. The study explored how increasing transplant rates could help lower the costs of dialysis and reduce how long people wait for a kidney. This work was part of a larger research program that aims to support decisions around donation laws and help other provinces learn from Nova Scotia’s experience.