title: The cost of kidney transplant over time.
abstract: BACKGROUND
  Kidney transplant improves quality of life and survival compared with dialysis. Despite advances in immunosuppressant regimens and the prevention and treatment of acute rejection, graft survival rates have not improved significantly in the past decade. Although the clinical effectiveness of these regimens has been studied, the impact of changes over time on cost has not.
  
  
  METHODS
  Costs of kidney transplant were compared between 2 periods demarcated by a programmatic change from cyclosporine (early) to tacrolimus (late) and from nonroutine induction (early) to routine induction (late) therapy in adult patients receiving a first kidney-only transplant in Calgary, Alberta, Canada, in an 8-year period.
  
  
  RESULTS
  Complete costs for 3 years after transplant was available for 344 patients, including 161 adult recipients in the early period (April 1, 1998-December 31, 2001) and 183 adult recipients in the late period (January 1, 2002-March 31, 2006). The mean total 3-year cost of transplant for recipients was Can$100 034 in the early period and Can$144 712 in the late period largely attributed to increases in the cost of immunosuppressants (P< .001).
  
  
  CONCLUSIONS
  Given that the cost of transplant has increased significantly over time, the cost-effectiveness of these and other immunosuppressive regimens should be evaluated carefully.
authors.affiliation: University of Calgary, Canada.
authors.forename: Lianne
authors.initials: L
authors.lastname: Barnieh
authors.affiliation: University of Calgary, Canada.
authors.forename: Serdar
authors.initials: S
authors.lastname: Yilmaz
authors.affiliation: University of Calgary, Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: McLaughlin
authors.affiliation: University of Calgary, Canada.
authors.forename: Brenda R
authors.initials: BR
authors.lastname: Hemmelgarn
authors.affiliation: University of Alberta, Canada.
authors.forename: Scott
authors.initials: S
authors.lastname: Klarenbach
authors.affiliation: University of Calgary, Canada.
authors.forename: Braden J
authors.initials: BJ
authors.lastname: Manns
authors.lastname: For The Alberta Kidney Disease Network
mesh_terms: D000416:Alberta; D000911:Antibodies, Monoclonal / Q000191:economics; D016572:Cyclosporine / Q000191:economics; D005260:Female; D006084:Graft Rejection / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000191:economics
chemical_list: D000911:Antibodies, Monoclonal; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus