Cost-Effectiveness Analysis of Everolimus versus Mycophenolate in Kidney Transplant Recipients Receiving No Pharmacological Prophylaxis for Cytomegalovirus Infection: A Short-Term Pharmacoeconomic Evaluation (12 Months)
| Autor: | A. Bessa, Mayara Ivani de Paula, Camila Pepe, Helio Tedesco-Silva, Liliane Lumi Hiramoto, Juliana Mansur, Lucas Fahham, Alexandra Nicolau Ferreira Brigido, Claudia Rosso Felipe, Priscila Ruppel, Suelen Stopa, Jose O. Medina-Pestana, Laila Almeida Viana, Marina Pontello Cristelli |
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| Rok vydání: | 2017 |
| Předmět: |
Graft Rejection
medicine.medical_specialty Basiliximab Cost effectiveness Cost-Benefit Analysis Economics Econometrics and Finance (miscellaneous) 030230 surgery 03 medical and health sciences 0302 clinical medicine Prednisone Internal medicine medicine Animals Humans Economics Pharmaceutical Everolimus Prospective Studies Enzyme Inhibitors Intensive care medicine Adverse effect Pharmacology Toxicology and Pharmaceutics (miscellaneous) business.industry 030503 health policy & services Health Policy Cost-effectiveness analysis Mycophenolic Acid Kidney Transplantation Tacrolimus Transplantation Cytomegalovirus Infections Rabbits 0305 other medical science business Immunosuppressive Agents medicine.drug |
| Zdroj: | Value in health regional issues. 14 |
| ISSN: | 2212-1102 |
| Popis: | Background Modern immunosuppressive regimens, although associated with improved 1-year graft survival, are associated with adverse effects, including opportunistic infections, diabetes mellitus after transplantation, cardiovascular complications, and de novo malignancies. Objectives To determine the short-term (12 months) cost-effectiveness of everolimus (EVR) versus mycophenolate sodium (MPS) in kidney transplant recipients receiving induction therapy, tacrolimus, prednisone, and no prophylaxis for cytomegalovirus infection. Methods A Markov state transition model was designed. Data from a single-center prospective trial were used along with data from the center's medical bills database. The target population comprised adults with low immunological risk submitted to first ABO-compatible transplantation with kidneys recovered from living or deceased donors. The time horizon was 12 months. The interventions included tacrolimus and prednisone plus a single 3-mg/kg dose of rabbit antithymocyte globulin (ATG) and EVR or basiliximab (BAS) and EVR or BAS and MPS. The clinical outcomes considered for this analysis were cytomegalovirus infection/disease, acute rejection, graft dysfunction, surgical complications, graft loss, and life-years gained. Results ATG/EVR was cost-saving compared with BAS/MPS on all evaluated outcomes; BAS/EVR outperformed BAS/MPS on most of the evaluated outcomes. Results were confirmed by sensitivity analysis. Conclusions Compared with MPS, EVR is an alternative immunosuppressive agent that is able to provide resource-saving to the health care provider with effectiveness gains for the patient. |
| Databáze: | OpenAIRE |
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