Economic Evaluation of Screening for Polyomavirus Infection in Kidney Transplant Recipients: A Cost-Utility Analysis.

Autor:	Wong G; Sydney School of Public Health, University of Sydney, NSW, Australia.; Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, NSW, Australia.; Centre for Renal and Transplantation Research, Westmead Hospital, NSW, Australia., Myint TM; Sydney School of Public Health, University of Sydney, NSW, Australia.; Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, NSW, Australia., Lee YJ; University of Iowa, Iowa City, IA., Craig JC; College of Medicine and Public Health, Flinders University, Adelaide, Australia., Axelrod D; University of Iowa, Iowa City, IA., Kiberd B; Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Jazyk:	angličtina
Zdroj:	Transplantation direct [Transplant Direct] 2022 Apr 15; Vol. 8 (5), pp. e1318. Date of Electronic Publication: 2022 Apr 15 (Print Publication: 2022).
DOI:	10.1097/TXD.0000000000001318
Abstrakt:	Screening for polyomavirus infection after kidney transplantation is recommended by clinical practice guidelines, but cost-effectiveness of this strategy is uncertain. The aim of this study was to estimate the incremental costs and benefits of routine screening for polyomavirus infection compared with no screening in kidney transplant recipients. Methods: Probabilistic Markov models were constructed to compare the health and economic benefits of routine screening for polyomavirus infection using real-time polymerase chain reaction assay. A series of 1-way and probabilistic sensitivity analyses were conducted to define the most influential variables in the model. Results: Monthly screening for 6 mo followed by 3 monthly screenings until 12 mo after transplant was dominant (lower costs and improved outcomes). Compared with no screening, the incremental benefits of screening were 0.294 life-years saved and 0.232 quality-adjusted life-years saved. Total savings from screening were $6986 Australian dollars ($5057 US dollars). The cost-effectiveness ratios were most sensitive to the costs of transplantation and dialysis, age of transplantation, prevalence of viremia, and probability of death in patients with a history of polyomavirus-associated nephropathy. Probabilistic sensitivity analysis indicated that screening (compared with no screening) was the dominant strategy across all plausible ranges of transition probabilities. Conclusions: Screening for polyomavirus infections 1 year following transplantation appears to save money, improves survival, and improves quality of life in kidney transplant recipients. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 The Author(s). Transplantation Direct. Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu