[Cyclosporine versus tacrolimus in kidney transplants in Brazil: a cost comparison].
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.
Guerra Junior
Augusto Afonso
AA
Universidade Federal de Minas Gerais, Belo Horizonte, Brasil. augustoguerra@ig.com.br
Acúrcio
Francisco de Assis
Fde A
Andrade
Eli Iola Gurgel
EI
Cherchiglia
Mariângela Leal
ML
Cesar
Cibele Comini
CC
Queiroz
Odilon Vanni de
OV
Silva
Grazielle Dias da
GD
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
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus