Cyclosporine versus tacrolimus: cost-effectiveness analysis for renal transplantation in Brazil.
OBJECTIVE To analyze the cost-effectiveness of treatment regimens with cyclosporine or tacrolimus, five years after renal transplantation. METHODS This cost-effectiveness analysis was based on historical cohort data obtained between 2000 and 2004 and involved 2,022 patients treated with cyclosporine or tacrolimus, matched 1:1 for gender, age, and type and year of transplantation. Graft survival and the direct costs of medical care obtained from the National Health System (SUS) databases were used as outcome results. RESULTS Most of the patients were women, with a mean age of 36.6 years. The most frequent diagnosis of chronic renal failure was glomerulonephritis/nephritis (27.7%). In five years, the tacrolimus group had an average life expectancy gain of 3.96 years at an annual cost of R$78,360.57 compared with the cyclosporine group with a gain of 4.05 years and an annual cost of R$61,350.44. CONCLUSIONS After matching, the study indicated better survival of patients treated with regimens using tacrolimus. Moreover, regimens containing cyclosporine were more cost-effective [corrected].
Augusto Afonso
AA
Guerra Júnior
Grazielle Dias
GD
Silva
Eli Iola Gurgel
EI
Andrade
Mariângela Leal
ML
Cherchiglia
Juliana de Oliveira
Jde O
Costa
Alessandra Maciel
AM
Almeida
Francisco de Assis
Fde A
Acurcio
D000328:Adult; D015331:Cohort Studies; D017046:Cost Savings; D003362:Cost-Benefit Analysis / Q000191:economics*; D016572:Cyclosporine / Q000191:economics* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006085:Graft Survival; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics* / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000191:economics / Q000601:surgery*; D016030:Kidney Transplantation / Q000191:economics*; D008297:Male; D019057:Quality-Adjusted Life Years; D016559:Tacrolimus / Q000191:economics* / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus