Economic implications of the use of basiliximab in addition to triple immunosuppressive therapy in renal allograft recipients: a UK perspective.
OBJECTIVE
To compare resource use and costs in renal transplant recipients treated with basiliximab or placebo plus triple immunosuppressive therapy.


METHODS
International randomised, double-blind, placebo-controlled trial; economic evaluation undertaken alongside the efficacy trial. The economic evaluation was performed from a UK National Health Service hospital perspective.


METHODS
31 centres in 12 countries.


METHODS
345 renal transplant recipients were enrolled; 340 were randomised (basiliximab 168; placebo 172) and included in the intention-to-treat analysis.


METHODS
Treatment with placebo or basiliximab (20mg intravenous bolus) on day 0 and day 4 after transplantation.


METHODS
Resource utilisation in multiple categories and treatment costs for basiliximab and placebo-treated patients during the 6-month post-transplantation period.


RESULTS
No statistically significant differences were found in any of the economically important categories of resource use or in the mean cost of treatment per person across the whole trial. The mean cost of treatment, including the cost of basiliximab, was pound 16 095 for basiliximab recipients and pound 15 864 (1997/1998 costs) for placebo recipients, a mean difference of pound 231 (95% CI: - pound 1983 to pound 2446), which was not significant. Basiliximab treatment led to a significant reduction in acute rejection episodes (basiliximab 20.8%; placebo 34.9%; p = 0.005).


CONCLUSIONS
Basiliximab therapy confers a significant clinical benefit to renal transplant recipients without increasing overall treatment costs.
Walters
Stephen J
SJ
School of Health and Related Research, University of Sheffield, Sheffield, UK. s.j.walters@sheffield.ac.uk
Whitfield
Malcolm
M
Akehurst
Ronald L
RL
Chilcott
James B
JB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000191:economics*; D000077552:Basiliximab; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005260:Female; D006084:Graft Rejection / Q000191:economics / Q000453:epidemiology / Q000276:immunology; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000191:economics*; D016030:Kidney Transplantation / Q000191:economics* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011993:Recombinant Fusion Proteins; D016896:Treatment Outcome; D006113:United Kingdom
D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D010919:Placebos; D011993:Recombinant Fusion Proteins; D000077552:Basiliximab