Economic evaluation of sirolimus-based immunosuppressive regimens in kidney graft recipients

Transplant Proc. 2006 Jan-Feb;38(1):74-7. doi: 10.1016/j.transproceed.2005.11.092.

Abstract

Introduction: The aim of this study was an economic evaluation of three sirolimus (SRL)-based regimens in the first 2 years after renal transplantation.

Materials and methods: The three SRL-based immunosuppressive regimens in renal transplant patients between June 2000 and September 2002 were: (1) SRL + steroids + cyclosporine (CsA) permanently; (2) SRL + steroids + tacrolimus (Tac); and (3) SRL + steroids + CsA, with CsA discontinuation at 3 months posttransplant. Ten patients were included in each group in an intent-to-treat analysis. Cost was calculated according to the hospital price list and recast into euros (EUR) with a 5% discount rate.

Results: The number of patients free of an acute rejection episode during 2 years posttransplant were 6, 8, and 5, with 2-year graft and patient survivals of 9, 10, and 9 for regimens 1, 2, and 3, respectively. As differences in clinical effects were not statistically significant, cost analysis was appropriate instead of cost-effectiveness analysis. The mean cost of the 2-year treatment was 15,759 EUR; 25,593 EUR; and 21,197 EUR per patient for regimens 1, 2, and 3, respectively. Sensitivity analysis for the main variables confirmed that the results were not dependent on changes in costs.

Conclusions: Regimen 1 was the most economical immunosuppressive therapy during the 2 years after kidney transplantation. Studies on a larger group of longer observation would be more useful for clinical analysis.

MeSH terms

  • Adult
  • Aged
  • Cost of Illness
  • Female
  • Graft Rejection / epidemiology
  • Graft Survival / physiology
  • Histocompatibility Testing
  • Humans
  • Immunosuppressive Agents / economics
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / classification
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / economics
  • Kidney Transplantation / immunology*
  • Kidney Transplantation / mortality
  • Male
  • Middle Aged
  • Poland
  • Retrospective Studies
  • Sirolimus / economics
  • Sirolimus / therapeutic use*
  • Survival Analysis
  • Tissue Donors / classification

Substances

  • Immunosuppressive Agents
  • Sirolimus