title: [Cyclosporine versus tacrolimus in kidney transplants in Brazil: a cost comparison].
abstract: In Brazil, the Unified National Health System (SUS) is responsible for the majority of kidney transplants. To maintain these interventions, the guidelines recommend the use of cyclosporine or tacrolimus, associated with corticosteroids and azathioprine or mycophenolate. Taking the perspective of the National Health System, an economic analysis was performed on the outpatient and hospital resources and medicines used by patient and therapeutic group. A cohort was constructed from 2000 to 2004, with 5,174 kidney transplant patients in use of cyclosporine or tacrolimus, identified by probabilistic record linkage from the National Health System. The cohort included 4,015 patients in use of cyclosporine and 1,159 using tacrolimus. The majority were males, age < 38 years, with nephritis, cardiovascular diseases, and indeterminate causes as the most frequent primary diagnoses. After 48 months of follow-up, the expenditures were higher for kidney transplants in hospitals in the Northeast, cadaver donors, patients in dialysis > 24 months before the transplant, and in the tacrolimus group. Total hospital and outpatient costs and expenditure on medication were higher in patients on tacrolimus as compared to the cyclosporine group.
authors.affiliation: Universidade Federal de Minas Gerais, Belo Horizonte, Brasil. augustoguerra@ig.com.br
authors.forename: Augusto Afonso
authors.initials: AA
authors.lastname: Guerra Junior
authors.forename: Francisco de Assis
authors.initials: Fde A
authors.lastname: Acúrcio
authors.forename: Eli Iola Gurgel
authors.initials: EI
authors.lastname: Andrade
authors.forename: Mariângela Leal
authors.initials: ML
authors.lastname: Cherchiglia
authors.forename: Cibele Comini
authors.initials: CC
authors.lastname: Cesar
authors.forename: Odilon Vanni de
authors.initials: OV
authors.lastname: Queiroz
authors.forename: Grazielle Dias da
authors.initials: GD
authors.lastname: Silva
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016572:Cyclosporine / Q000191:economics* / Q000627:therapeutic use; D006084:Graft Rejection / Q000191:economics / Q000517:prevention & control*; D017048:Health Care Costs; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D016559:Tacrolimus / Q000191:economics* / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus