Nephrol Dial Transplant (2001) 16: 1028-1033
© 2001 European Renal Association-European Dialysis and Transplant Association
An economic and quality-of-life assessment of basiliximab vs antithymocyte globulin immunoprophylaxis in renal transplantation
1 Division of General Internal Medicine, University of Pennsylvania, Philadelphia, PA, 2 Center for Clinical and Genetic Economics, Duke Clinical Research Institute, Durham, NC, 3 University of Michigan Medical Center, Ann Arbor, MI, 4 Novartis Pharmaceuticals, East Hanover, NJ, USA
Background. Immunosuppressive therapy with cyclosporin A has substantially improved clinical outcomes for renal transplantation. Whether basiliximab (a chimeric monoclonal antibody) demonstrates economic and quality-of-life advantages over other induction therapies has not yet been shown.
Methods. A multi-centre open-label clinical trial was conducted among renal transplant recipients in the US, in which patients were randomized into two induction therapy regimens: basiliximab and antithymocyte globulin (ATG) as part of a quadruple immunosuppressive regimen. Medical resources used and a EuroQol visual analogue scale (VAS) rating of quality of life were collected prospectively for the 135 dosed subjects for a period of 1 year post-treatment. We analysed the differences between treatment groups in 1-year costs and 1-year quality-adjusted survival. We also conducted a post hoc analysis of outcomes among the subgroup of patients identified as high risk.
Results. A significant difference was observed in first-year post-treatment costs (basiliximab, $45857; ATG, $54729; difference, $8872 (95% CI, $1169 to $16573). The savings from basiliximab can be attributed to the less expensive induction therapy (basiliximab, $2378; ATG, $8670; difference, $6292 (95% CI, $5165 to $7419)) and other savings during the initial hospitalization totalling $2609. One-year quality-adjusted survival was the same in both groups (basiliximab, 81.5; ATG, 81.1; difference, 0.45 (95% CI, -5.9 to 6.8)). The results of the post hoc analysis of the 48 high-risk patients were comparable to the analysis of all patients.
Conclusions. These results demonstrate lower first-year post-treatment costs in renal-transplant recipients receiving basiliximab compared to ATG with no differences in quality-adjusted survival. The results also suggest similar differences among high-risk subjects.
Keywords: cost and cost analysis; cost effectiveness; immunoprophylaxis; immunosuppressive agents; kidney transplant; quality of life
Correspondence and offprint requests to: Daniel Polsky PhD, Division of General Internal Medicine, University of Pennsylvania, Blockley Hall, Rm. 1212, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. L. Morton, K. Howard, A. C. Webster, G. Wong, and J. C. Craig The cost-effectiveness of induction immunosuppression in kidney transplantation Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2258 - 2269. [Abstract] [Full Text] [PDF]
|
|