English, Article edition: The Economic Implications of Non-Adherence after Renal Transplantation Irina Cleemput; Katrien Kesteloot; Yves Vanrenterghem; ...

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Physical Description
  • article
Language
  • English

Edition details

Title
  • The Economic Implications of Non-Adherence after Renal Transplantation
Author
  • Irina Cleemput
  • Katrien Kesteloot
  • Yves Vanrenterghem
  • Sabina De Geest
Physical Description
  • article
Notes
  • Background: The economic impact of therapeutic non-adherence in chronic diseases has rarely been examined using qualitative standards for economic evaluation. This study illustrates the impact of non-adherence on the cost utility of renal transplantation versus haemodialysis from the societal perspective and examines the scope for adherence-enhancing interventions. Methods: Long-term costs and outcomes in adherent and non-adherent renal transplant patients were simulated in a Markov model. The cost (euros, year 2000 values) and outcome data that were imputed in the model were derived from a prospective study in renal transplantation candidates performed in 2002. Probabilities of adverse events, graft rejection, graft loss and death in adherent and non-adherent renal transplant patients were derived from literature. Results: Compared with dialysis, renal transplantation offers a better outcome in both adherent and non-adherent patients. Lifetime costs after transplantation in the adherent patient group are higher than lifetime dialysis costs and lifetime costs in the non-adherent patient group, mainly because adherent patients live longer after transplantation. Long-term outcomes after transplantation are better for adherent than for non-adherent patients. The mean cost per QALY gained in adherent patients relative to non-adherent patients was Conclusion: Compared with established healthcare interventions, such as haemodialysis, renal transplantation can be considered a cost-effective therapy for patients with end-stage renal disease, even if patients are non-adherent after transplantation. The low incremental cost per QALY calculated in this model for adherent renal transplant patients, suggests there may be scope
  • Cost-utility, Dialysis, Immunosuppressants, Patient-compliance, Renal-failure, Renal-transplant-rejection
  • RePEc:wkh:phecon:v:22:y:2004:i:18:p:1217-1234
Language
  • English
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