title: Economic evaluation of everolimus versus mycophenolate mofetil in combination with cyclosporine and prednisolone in de novo renal transplant recipients.
abstract: An economic evaluation was undertaken alongside a multicentre, international, trial of everolimus (Certican). Resource usage within the trial was assessed, and the cost implications of the use of everolimus were evaluated. Recipients of a primary cadaveric kidney transplant were recruited into a double-blind trial and received either everolimus 1.5 mg (n=194); everolimus 3 mg (n=198) or mycophenolate mofetil (MMF) 2 g (n=196). Clinical outcomes and resource usage were monitored for 12 months following transplantation. Local costs were obtained, and global analysis using health sector PPP rates was undertaken. The mean overall cost of treatment was 33,715 dollars (95%CI 30,013 dollars-37,417 dollars) with everolimus 1.5 mg, 38,519 dollars (95%CI 34,094 dollars-42,943 dollars) with everolimus 3 mg and 36,509 dollars (95%CI 32,430 dollars-40,587 dollars) with MMF. Differences between the three groups did not reach statistical significance. In conclusion, the economic analysis showed statistical equivalence over the three arms of the trial. Further work is required to demonstrate the cost consequences of the use of everolimus compared with MMF in renal transplantation patients.
authors.affiliation: School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK, M.W.Holmes@sheffield.ac.uk
authors.forename: Michael
authors.initials: M
authors.lastname: Holmes
authors.forename: Jim
authors.initials: J
authors.lastname: Chilcott
authors.forename: Stephen
authors.initials: S
authors.lastname: Walters
authors.forename: Simon
authors.initials: S
authors.lastname: Whitby
authors.forename: Ron
authors.initials: R
authors.lastname: Akehurst
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D016572:Cyclosporine / Q000191:economics* / Q000627:therapeutic use; D004311:Double-Blind Method; D016527:Drug Costs; D004359:Drug Therapy, Combination; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000191:economics / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use; D011239:Prednisolone / Q000191:economics* / Q000627:therapeutic use; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000191:economics* / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D000068338:Everolimus; D011239:Prednisolone; D009173:Mycophenolic Acid; D020123:Sirolimus