title: Economic analysis of Neoral in de novo renal transplant patients in Canada.
abstract: This pilot economic evaluation was performed as part of the Canadian arm of an international randomized, controlled, double-blind safety and tolerability trial (OLM-105/NOF-2). The clinical study compared the safety and tolerability of a new microemulsion oral formulation of cyclosporine A (Neoral) with the oral cyclosporine. A preparation currently in use (Sandimmune SGC)/(SGC). To assess the economic impact of Neoral in newly grafted renal transplant patients, primary cost data were collected at the five participating Canadian centers and evaluated from the Ministry of Health (MOH) and hospital perspectives. The results of this cost analysis are presented in this paper. Since the new formulation has shown more consistent absorption and a more predictable pharmacokinetic profile, medical resource utilization and, consequently, cost of treatment could be expected to be lower for those renal transplant recipients treated with Neoral than for those receiving standard SGC. The findings of this study support this hypothesis. Robustness of the conclusion was confirmed with sensitivity analyses. Reduced health care costs for patients treated with Neoral were primarily a result of fewer hospitalization days and lower physician costs for inpatient and outpatient procedures.
authors.affiliation: Université Laval, Quebec, Canada.
authors.forename: I
authors.initials: I
authors.lastname: Kingma
authors.forename: D
authors.initials: D
authors.lastname: Ludwin
authors.forename: R
authors.initials: R
authors.lastname: Dandavino
authors.forename: J L
authors.initials: JL
authors.lastname: Wolff
authors.forename: R
authors.initials: R
authors.lastname: Loertscher
authors.forename: L
authors.initials: L
authors.lastname: Beauregard-Zollinger
authors.forename: P
authors.initials: P
authors.lastname: Bacquet
authors.forename: S
authors.initials: S
authors.lastname: Boucher
authors.forename: M
authors.initials: M
authors.lastname: Rivière
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D002170:Canada; D016572:Cyclosporine / Q000008:administration & dosage* / Q000191:economics* / Q000627:therapeutic use; D004311:Double-Blind Method; D016527:Drug Costs; D004655:Emulsions; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000191:economics*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D008875:Middle Aged
chemical_list: D004655:Emulsions; D007166:Immunosuppressive Agents; D016572:Cyclosporine