Cost effectiveness of a new combined immunosuppressive and antiviral regimen on the one-year follow-up of kidney transplant patients.

Détails

ID Serval
serval:BIB_5E497D8BE410
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Titre
Cost effectiveness of a new combined immunosuppressive and antiviral regimen on the one-year follow-up of kidney transplant patients.
Titre de la conférence
8th American Transplant Congress
Auteur(s)
Manuel Oriol, Kast-Bruechner Mira, Venetz Jean-Pierre, Meylan Pascal R., Pascual Manuel, Wasserfallen Jean-Blaise
Adresse
Toronto, Canada, May 31-June 4, 2008
ISBN
1600-6135
Statut éditorial
Publié
Date de publication
2008
Peer-reviewed
Oui
Volume
8
Série
American Journal of Transplantation
Pages
395-395
Langue
anglais
Notes
Publication type : Meeting Abstract
Résumé
Background: Medical prescription after organ transplant must prevent both rejection and
infectious complications. We assessed the 1-year effectiveness and cost of introducing
a new combined regimen in kidney transplantation.
Methods: Patients transplanted from January 2000 to March 2003 (Period 1) were
compared to patients transplanted from April 2003 to July 2005 (Period 2). In period
1, patients were treated with Basiliximab, Cyclosporin, steroids and Mycophenolate
(MMF) or Azathioprine. Prophylaxis with Valacyclovir was prescribed only in CMV
D+/R- patients. In period 2, immunosuppressive drugs were Basiliximab, Tacrolimus,
steroids and MMF. A 3-month universal CMV prophylaxis with Valganciclovir was
used. Medical charts of outpatient visits allowed identifying drug, laboratory and
radiological tests use, and hospital information system causes of hospitalisation and
length of stay (LOS) over the first year after transplant. Patients with incomplete costs
data were excluded.
Results: 53 patients were analysed in period 1, and 60 in period 2. CMV serostatus
patterns were not significantly different between the 2 periods. Over 12 months,
acute rejection decreased from 22 patients (42%) in period 1 to 4 patients (7%) in
period 2 (p<0.001), and CMV infection from 25 patients (47%) to 9 patients (15%,
p<0.001). Average total rehospitalisation LOS decreased from 28±19 to 20±11 days
(p<0.007). Average outpatient visits decreased from 49±10 to 39±8 (p<0.001). Average
immunosuppression and CMV prophylaxis costs increased from US$ 18,362±6,546
to 24,637±5,457 (p<0.001), while average graft rejection costs decreased form US$
4,135±9,164 to 585±2,850 (p=0.005), and average CMV treatment costs from US$
2,043±5,545 to 91±293 (p=0.008). Average outpatient visits costs decreased from US$
7,619±1,549 to 6,074±1,043 (p<0.001), and other hospital costs from US$ 3,801±6,519
to 1,196±3,146 (p=0.007). Altogether, average 1-year treatment costs decreased from
US$ 35,961±14,916 to 32,584±6,211 (p=0.115). Cost-effectiveness ratios to avoid
graft rejection and CMV infection decreased from US$ 61,482±9,292 to 34,911± 1,639
(p=0.006) and US$ 68,070±11,122 to 39,899±2,650 (p=0.015), respectively.
Conclusion: The new combined regimen administered in period 2 was significantly more
effective. Its additional cost was more than offset by savings linked with complications
avoidance.
Mots-clé
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Web of science
Création de la notice
28/12/2010 15:04
Dernière modification de la notice
20/08/2019 14:16
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