The economics of basiliximab (Simulect) in preventing acute rejection in renal transplantation

Abstract

An economic evaluation was undertaken alongside a multicentre international trial of basiliximab. Resource usage within the trial was assessed, and the cost implications of using basiliximab evaluated. Recipients of a primary cadaveric kidney transplant were recruited into a double-blind trial and received either placebo (n = 186) or basiliximab (n = 190). Clinical outcomes and resource usage were monitored in the 12 months following transplantation. Local unit costs were obtained, and global analysis was undertaken using health sector purchasing-power parity rates. No statistically significant differences were found in the mean cost of treatment per patient. The mean cost of treatment was $47,940 for basiliximab patients and $46,280 for placebo patients, a mean difference of $1,660 (95% confidence interval Basiliximab produces clinical benefit in terms of preventing episodes of acute rejection, whilst the difference in the total resource usage and cost of treatment is not statistically significant .(CI): -$4,150, $7,360; P~0 . 5 8 ) .

Immunosuppressive therapy for kidney transplantation in adults: a systematic review and economic model

“…Five were studies of induction regimens, 312,[314][315][316][317] three of which were studies of UK adults, [315][316][317] and 10 were studies of initial and maintenance immunosuppression, 65,[307][308][309][310]318,319,321 four of which were of UK adults. 65,309,310,318 In what follows, studies of induction regimens are reviewed before reviewing studies of initial and maintenance immunosuppressive regimens, by country setting (UK vs. other).…”

“…Thirteen studies 65,[307][308][309][310]312,[314][315][316][317][318][319]321 were included in this review. Five were studies of induction regimens, 312,[314][315][316][317] three of which were studies of UK adults, [315][316][317] and 10 were studies of initial and maintenance immunosuppression, 65,[307][308][309][310]318,319,321 four of which were of UK adults.…”

“…Twelve economic evaluations were included in the review (published in 14 publications 65,306,[308][309][310][311][312][313][314][315][316][319][320][321] ). Update searches, conducted on 18 November 2014, yielded an additional six reports 42,307,318,324,325 on economic evaluations eligible for inclusion in the review.…”

“…Country-specific unit costs were adjusted for purchasing power parity (PPP) to reflect the actual opportunity costs of health-care resources in each country. 315 The study involved 376 people (BAS, n = 190; PBO, n = 186) and, as Walters et al 316 had found for 6-month post-transplantation outcomes, observed that BAS reduced the rate of (suspected) ARs (BAS 37%, PBO 54.8%; absolute risk difference (ARD) -16.9, 95% CI -29 to -4] without affecting graft loss (ARD -1.3, 95% CI -8.1 to 5.4) and patient survival (ARD 2.0, 95% CI -1.8 to 5.9) at 12 months. The authors report that no retransplantations were recorded in any group over the 12-month post-transplantation period studied.…”

“…The costs estimates were reported in terms of PPP US dollars (US$,1996 prices). After converting them back to PPP pounds sterling (£) using the £0.4 = US$1 conversion rate provided by the Chilcott et al 315 study (see Table 141), 315 the mean total per-patient cost in the BAS arm was £19,174 and £18,510 in the PBO arm (difference £664, 95% CI -£1660 to £2944). The incremental cost per suspected case of AR avoided at 12 months post transplantation was £3929.…”