We evaluated the cost-effectiveness of a standard immunosuppressive regimen versus an OKT3 induction regimen in cadaveric kidney transplant recipients.
Cost estimates were based on results from a five-center randomized trial comparing the safety and efficacy of OKT3 induction with a conventional triple-drug regimen and financial data from the National Cooperative Transplantation Study, the Medicare Provider and Analysis Review database, and other sources.
Patients received OKT3 (5 mg/day) by intravenous (IV) bolus injection for 10 to 14 consecutive days in conjunction with azathioprine, prednisone, and the delayed addition of cyclosporine (CsA) on day 11 (n=105) or a conventional immunosuppressive regimen consisting of CsA, azathioprine, and prednisone (n=102).
The following measures were used to evaluate the two regimens :
costs incurred between transplantation and graft failure ;
the effectiveness of the two regimens as defined by length of graft survival ;
and cost-effectiveness ratios through 5 years of observed follow-up and modeled through the expected duration of graft survival.
Results showed that OKT3 induction uniformly adds $8,219 to the cost of the transplant hospitalization.
However, most of this cost is offset by a reduction in the cost of treating rejection episodes in the OKT3 group (P=0.002).
A trend toward improved graft survival was detected in the OKT3 group (P=0.158). (...)
Mots-clés Pascal : Insuffisance rénale, Homotransplantation, Rein, Immunomodulateur, Postopératoire, Analyse coût efficacité, Economie santé, Evaluation, Traitement, Homme, Appareil urinaire pathologie, Rein pathologie, Transplantation, Chirurgie, Chimiothérapie, OKT3
Mots-clés Pascal anglais : Renal failure, Homotransplantation, Kidney, Immunomodulator, Postoperative, Cost efficiency analysis, Health economy, Evaluation, Treatment, Human, Urinary system disease, Renal disease, Transplantation, Surgery, Chemotherapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0321807
Code Inist : 002B02Q. Création : 10/04/1997.