[Economic contribution of mofetil mycofenolate as preventive immunosuppressive treatment after renal transplantation from cadaver].
OBJECTIVE
The economic impact resulting from the clinical consequences of immunosuppressive strategy using mycophenolate mofetil in new renal transplant recipients was conducted considering the viewpoint of the health insurance system.


METHODS
The analysis was based on the results of three controlled randomized double-blind clinical trials comparing mycophenolate mofetil with placebo or azathioprine in 1003 out of 1493 included patients respectively. Health care costs associated with each event were determined by 7 French experts in renal transplantation working in six different hospitals. Direct cumulative costs for each strategy were compared.


RESULTS
The studies demonstrated a difference in the incidence of acute rejection and treatment failures whatever the cause. The three trials showed that, compared with current strategies, use of mycophynolate mofetil in the immunosuppression protocol generated a 19 to 38% cost reduction during the 6 months after transplantation. Cost reduction resulted from lower incidence of acute rejection and the subsequent nephrectomics and dialysis sessions. The sensitivity analysis on the most important cost factors-cost of hospitalization per day and number of hospitalization days-confirmed strength of the results.


CONCLUSIONS
Use of mycophenolate mofetil in the immunosuppressive prophylaxis protocol after renal transplantation allows a reduction in the direct costs during the 6 months following transplantation.
Louis-Touizer
C
C
Affaires Economiques, Produits Roche, Neuilly-sur-Seine.
Nuijten
M J
MJ
Bayle
F
F
Cantarovich
D
D
Lang
P
P
Lebranchu
Y
Y
Le Pogamp
P
P
Touraine
J L
JL
Vialtel
P
P
Monroe
T
T
de Vries
M J
MJ
D000328:Adult; D000553:Ambulatory Care / Q000191:economics; D001379:Azathioprine / Q000191:economics; D002102:Cadaver; D003365:Costs and Cost Analysis; D006084:Graft Rejection; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000191:economics*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D010919:Placebos; D011183:Postoperative Complications / Q000191:economics / Q000628:therapy; D013997:Time Factors
D007166:Immunosuppressive Agents; D010919:Placebos; D009173:Mycophenolic Acid; D001379:Azathioprine
Apport économique du mycophénolate mofétil comme traitement immunosuppresseur prophylactique après transplantation rénale de cadavre.