[Cost-effectiveness analysis of immunosuppressive drugs in post-renal transplantation maintenance therapy in adult patients in Brazil].
The aim of the study was to perform cost-effectiveness analysis of immunosuppressive drugs in post-renal transplantation maintenance therapy. A hypothetical cohort of transplanted adults was followed for 20 years, using the Markov model. The 10 evaluated therapeutic regimens contained prednisone (P). Average cost of the medicines was obtained from CMED (Câmara de Regulação do Mercado de Medicamentos). Other patient care costs were included in each disease stage. Costs were expressed in Brazilian reais, effectiveness was measured as years of life gained, and the study adopted a public health system perspective. At the end of follow-up, the analysis with discount showed that all the regimens were dominated by cyclosporine (CSA)+azathioprine (AZA)+P. In the remaining analyses, tacrolimus+AZA+P was not dominated, but the incremental cost-effectiveness ratio between these two regimens was R$ 156,732.07/ years of life gained, a value that exceeds the threshold of three times the Brazilian per capita GDP. In the sensitivity analysis, no qualitative change was observed and the probability of CSA+AZA+P being the most cost-effective regimen was greater than 85%.
Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil. acurcio@medicina.ufmg.br
Francisco de Assis
Fde A
Acurcio
Faculdade de Farmácia, Universidade Federal de São João Del Rei, Divinópolis, Brasil.
Luciana Tarbes Mattana
LT
Saturnino
Superintendência de Assistência Farmacêutica e Insumos Estratégicos, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brasil.
Anderson Lourenço da
AL
Silva
Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Gustavo Laine Araújo de
GL
Oliveira
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Eli Iola Gurgel
EI
Andrade
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Mariangela Leal
ML
Cherchiglia
Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, Brasil.
Maria das Graças Braga
Md
Ceccato
D000328:Adult; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004359:Drug Therapy, Combination; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000191:economics*; D016030:Kidney Transplantation; D008390:Markov Chains; D016019:Survival Analysis
D007166:Immunosuppressive Agents