Mycophenolate mofetil--is it worth the cost? The in-favor opinion.
Since its introduction, mycophenolate mofetil (MMF) has rapidly gained acceptance among renal transplant physicians. Three large multicenter studies have shown that MMF decreased the incidence of acute rejection episodes by 50%. While clinical data supporting the long-term benefits of MMF are not available, there is some experimental evidence which demonstrates that MMF may play a role in the prevention of chronic allograft rejection. Furthermore, MM F is a potent immunosuppressive agent, which could result in a reduction of the dose of cyclosporin A (CsA) required and subsequently reduce its associated toxicity. Despite the fact that MMF is six to seven times more expensive than azathioprine (AZA), its introduction into maintenance immunosuppressive protocols may not increase renal transplant charges during the first year after renal transplant as its cost can be offset by the reduced number of acute rejection episodes (ARE). The long-term societal impact of MMF will need to be evaluated as the data related to graft and patient survival, as well as chronic rejection, become available.
Seikaly
M G
MG
University of Texas South-western Medical Center of Dallas, USA. mseika@childmed.dallas.tx.us
D000208:Acute Disease; D001379:Azathioprine / Q000191:economics / Q000627:therapeutic use; D002648:Child; D002908:Chronic Disease; D017281:Cost of Illness; D016572:Cyclosporine / Q000191:economics / Q000627:therapeutic use; D016527:Drug Costs; D006084:Graft Rejection / Q000188:drug therapy / Q000191:economics / Q000209:etiology / Q000517:prevention & control*; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D013673:Technology Assessment, Biomedical; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D009173:Mycophenolic Acid; D001379:Azathioprine