title: Pharmacoeconomic impact of different regimens to prevent cytomegalovirus infection in renal transplant recipients.
abstract: BACKGROUND
  The aim of this study was to determine the cost impact of four different strategies for prevention of cytomegalovirus (CMV) disease after renal transplantation.
  
  
  METHODS
  Hospitalization data and medical resource utilization data were prospectively collected alongside two randomized trials. In the first trial, the patients were randomized to 3-month prophylaxis with either oral ganciclovir (1 g t.i.d., n = 36) or valacyclovir (2 g q.i.d., n = 35), and to the control group (n = 12) managed by deferred therapy. In the second trial, the patients were randomly assigned to 3-month valacyclovir prophylaxis (n = 34) or preemptive therapy with valganciclovir (900 mg b.i.d. for a minimum of 14 days, n = 36) for significant CMV DNAemia. The cost analysis involved all real costs directly related to CMV during the first year after renal transplantation.
  
  
  RESULTS
  The mean CMV-associated costs per patient were EUR 4,581, 2,577, 4,968, and 8,050 in patients in the ganciclovir, valacyclovir, preemptive, and deferred therapy groups, respectively (p < 0.001). Valacyclovir prophylaxis was significantly less expensive than any other regimen. The cost of one episode of CMV disease was EUR 7,510 per patient. Due to excessive incidence of CMV disease, deferred therapy was the most expensive strategy (p < 0.001).
  
  
  CONCLUSIONS
  Valacyclovir prophylaxis is less expensive strategy compared with any other regimen.
authors.affiliation: Department of Internal Medicine I, Charles University Medical School and Teaching Hospital, Plzen, Czech Republic.
authors.forename: Lukas
authors.initials: L
authors.lastname: Kielberger
authors.forename: Mirko
authors.initials: M
authors.lastname: Bouda
authors.forename: Pavel
authors.initials: P
authors.lastname: Jindra
authors.forename: Tomas
authors.initials: T
authors.lastname: Reischig
mesh_terms: D000212:Acyclovir / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics; D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000191:economics*; D003586:Cytomegalovirus Infections / Q000191:economics* / Q000517:prevention & control*; D017850:Economics, Pharmaceutical; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000191:economics; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects / Q000191:economics*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics* / Q000517:prevention & control*; D011446:Prospective Studies; D000077483:Valacyclovir; D014633:Valine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000191:economics
chemical_list: D000998:Antiviral Agents; D014633:Valine; D000077483:Valacyclovir; D015774:Ganciclovir; D000212:Acyclovir