Cost Utility of Sirolimus versus Tacrolimus for the Primary Prevention of Graft Rejection in Renal Transplant Recipients in Mexico

Rely, K; Galindo-Suárez, R.M.; Alexandre, Pierre K.; García-García, Erika Gabriela; Muciño-Ortega, Emilio; Salinas-Escudero, Guillermo; Martínez-Valverde, Silvia

doi:10.1016/j.vhri.2012.09.013

Cited by 5 publications

(1 citation statement)

References 43 publications

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“…This is due to the significant differences in cost of the two alternatives. This result is consistent with a number of other economic models 13 , 26 , 27 published since the last NICE recommendations were published in 2004. 4 However, these studies should be interpreted with caution.…”

Section: Discussionsupporting

confidence: 90%

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in England and Wales

Muduma¹,

Shaw²,

Hart³

et al. 2014

PPA

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BackgroundEnd-stage renal disease is the irreversible final stage of chronic kidney disease and is fatal when not managed by either transplantation or dialysis. Transplantation is generally preferred over dialysis. However, to prevent graft rejection or loss, lifelong immunosuppression is required. Tacrolimus is currently the cornerstone of post-transplantation immunosuppression. The study aim was to carry out an economic evaluation of immunosuppression, including more recent agents such as a once-daily prolonged-release formulation of tacrolimus (Advagraf™) and belatacept, relative to a twice-daily immediate-release formulation of tacrolimus (Prograf™).MethodsA model was constructed comprising six states: onset of biopsy-confirmed acute rejection, functioning graft with or without a biopsy-confirmed acute rejection, non-functioning graft (dialysis), re-transplantation, and death. Data on clinical effectiveness were derived from a systematic literature review and the model captured the effects of patient adherence to immunosuppressant therapy on graft survival using relative risk of graft survival and published data on adherence in patients using Advagraf and Prograf. In the base case, the time horizon was 25 years and one-way and probabilistic sensitivity analyses were conducted.ResultsThe analysis demonstrated that Prograf was cost-effective when compared with cyclosporin and belatacept and was more effective than sirolimus, but would not be considered cost-effective against sirolimus. The modeled improvement in the adherence profile of patients using Advagraf relative to Prograf resulted in both improved clinical outcomes and reduced costs.ConclusionPrograf was more clinically effective than cyclosporin, belatacept, and sirolimus, supporting its current positioning as the mainstay of immunosuppressive therapy in renal transplant recipients. Based on improved patient adherence with Advagraf, the model projected that Advagraf would be both more effective and less costly than Prograf. Replacing Prograf with Advagraf as the standard of care for post-transplant immunosuppression could likely result in both cost savings and improved clinical outcomes.

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Section: Discussionsupporting

confidence: 90%

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in England and Wales

Muduma¹,

Shaw²,

Hart³

et al. 2014

PPA

View full text Add to dashboard Cite

show abstract

Markov model and meta-heuristics combined method for cost-effectiveness analysis

et al. 2019

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Future Prospects for Pharmacoeconomics and Outcomes Research in the Emerging Regions

Drummond

2013

Value in Health Regional Issues

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Cost Utility of Sirolimus versus Tacrolimus for the Primary Prevention of Graft Rejection in Renal Transplant Recipients in Mexico

Abstract: These analyses suggest that in the Mexican setting, the use of SIR in place of TAC for the prevention of graft rejection in this population is likely to be cost saving.

Cited by 5 publications

References 43 publications

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in England and Wales

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in England and Wales

Markov model and meta-heuristics combined method for cost-effectiveness analysis

Future Prospects for Pharmacoeconomics and Outcomes Research in the Emerging Regions

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Cost Utility of Sirolimus versus Tacrolimus for the Primary Prevention of Graft Rejection in Renal Transplant Recipients in Mexico

Abstract: These analyses suggest that in the Mexican setting, the use of SIR in place of TAC for the prevention of graft rejection in this population is likely to be cost saving.

Cited by 5 publications

References 43 publications

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in&nbsp;England and Wales

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in&nbsp;England and Wales

Markov model and meta-heuristics combined method for cost-effectiveness analysis

Future Prospects for Pharmacoeconomics and Outcomes Research in the Emerging Regions

Contact Info

Product

Resources

About

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in England and Wales

Cost utility analysis of immunosuppressive regimens in adult renal transplant recipients in England and Wales