title: The economic burden of posttransplant events in renal transplant recipients in Europe.
abstract: BACKGROUND
  This study aims to describe the healthcare resource utilization and costs of managing renal posttransplant patients over 3 years posttransplant in nine European countries and to stratify them by year 1 glomerular filtration rate (GFR).
  
  
  METHODS
  A retrospective observational and database analysis of renal transplant patients and a physician questionnaire study were conducted to collect recipient and donor characteristics, posttransplant events, and healthcare resource utilization related to these posttransplant events. In each country, local published costs were applied to the resource use identified. The results were stratified by the patient GFR reading at a time point 1 year after renal transplant.
  
  
  RESULTS
  The database study identified 3,181 patients who met the inclusion criteria, along with 2,818 transplants carried out in the centers surveyed by questionnaire. Total 3-year costs derived from the questionnaire analysis vary depending on local treatment practices, from a minimum of &OV0556;33,602 per patient in the Czech Republic to &OV0556;77,461 per patient in the Netherlands. Consistently across countries, estimated costs appear to decrease with improved graft functioning status (increased GFR) at 1 year. The average 3-year costs, discounting immunosuppression therapy and certain posttransplant events, per patient with a GFR greater than or equal to 60 at 1 year are estimated to be around 35% lower than those with 15≤GFR<30.
  
  
  CONCLUSIONS
  This study demonstrates that in Europe, worsening posttransplant renal function may contribute to substantive increases in resource use, with some variation across regions. Therefore, management strategies that promote renal function after transplantation have the potential to provide important resource savings.
authors.affiliation: 1 Swansea Centre for Health Economics, Swansea University, Swansea, UK. 2 Division of Nephrology, University Hospital of Wales, Cardiff, UK. 3 Health Economics and Outcomes Research Europe, Bristol Myers Squibb Ltd., Paris, France. 4 Address correspondence to: George Chamberlain, Swansea Centre for Health Economics, Westgate House, Womanby Street, Cardiff, CF10 1BR, UK.
authors.forename: George
authors.initials: G
authors.lastname: Chamberlain
authors.forename: Keshwar
authors.initials: K
authors.lastname: Baboolal
authors.forename: Hayley
authors.initials: H
authors.lastname: Bennett
authors.forename: Rhys D
authors.initials: RD
authors.lastname: Pockett
authors.forename: Phil
authors.initials: P
authors.lastname: McEwan
authors.forename: Javier
authors.initials: J
authors.lastname: Sabater
authors.forename: Karin
authors.initials: K
authors.lastname: Sennfält
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D016208:Databases, Factual / Q000706:statistics & numerical data; D005060:Europe / Q000453:epidemiology; D005260:Female; D005919:Glomerular Filtration Rate; D017048:Health Care Costs / Q000706:statistics & numerical data; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000191:economics* / Q000453:epidemiology / Q000601:surgery; D016030:Kidney Transplantation / Q000191:economics* / Q000401:mortality / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000191:economics* / Q000453:epidemiology / Q000401:mortality; D040841:Resource Allocation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires