English, Article edition: The Cost Effectiveness of Tacrolimus versus Microemulsified Cyclosporin: A 10-Year Model of Renal Transplantation Outcomes Michelle E. Orme; Wieslaw A. Jurewicz; Nagappan Kumar; ...

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Physical Description
  • article
Language
  • English

Edition details

Title
  • The Cost Effectiveness of Tacrolimus versus Microemulsified Cyclosporin: A 10-Year Model of Renal Transplantation Outcomes
Author
  • Michelle E. Orme
  • Wieslaw A. Jurewicz
  • Nagappan Kumar
  • Tracy L. McKechnie
Physical Description
  • article
Notes
  • Introduction and objective: In 1983, the launch of cyclosporin was a significant clinical advance for organ transplant recipients. Subsequent drug research led to further advances with the introduction of cyclosporin microemulsion (cyclosporin ME) and tacrolimus. This paper presents the results from a long-term model comparing the clinical and economic outcomes associated with cyclosporin ME and tacrolimus immunosuppression for the prevention of graft rejection following renal transplantation. Study design: A model was developed to project the costs and outcomes over a 10-year period following transplantation. The model was based on the results of a prospective, randomised study of 179 renal transplantation recipients receiving either cyclosporin ME or tacrolimus, which was conducted by the Welsh Transplantation Research Group (median follow-up: 2.7 years). Methods: The short-term costs and outcomes were the averages from the actual head-to-head trial data. From this, the long-term costs and outcomes were extrapolated based on the rate of change in patient and graft survival at 3, 5 and 10 years post transplant, as reported in the 1995 United Kingdom Transplant Support Service Authority Renal Transplant Audit. Perspective and year of cost data: The analysis was conducted from the perspective of a UK transplant unit. Costs were at 1999 prices (Lstg 1 =​ $US1.42 =​ Results: The model estimated that 10 years after transplantation, the proportion of patients surviving was 56% of the cyclosporin ME cohort and 64% of the tacrolimus cohort. The cumulative cost of maintenance therapy at 10 years was Lstg 23 Conclusion: Renal transplant recipients maintained on tacrolimus have better short- and long-term outcomes than patients maintained on cyclosporin ME. The long-term use of tacrolimus is a more cost-effective solution in terms of the number of survivors, patients with a functioning graft and rejection-free patients.
  • Ciclosporin, Cost-effectiveness, Immunosuppressants, Microemulsion, Pharmacoeconomics, Renal-transplant-rejection, Tacrolimus
  • RePEc:wkh:phecon:v:21:y:2003:i:17:p:1263-1276
Language
  • English
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