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Transpl Int. 2017 Oct;30(10):1011-1019. doi: 10.1111/tri.12991. Epub 2017 Jul 24.

Induction therapy with rabbit antithymocyte globulin versus basiliximab after kidney transplantation: a health economic analysis from a German perspective.

Author information

1
Department of Nephrology, University Hospital Eppendorf UKE, Hamburg, Germany.
2
Nephrology, Rheumatology, Diabetology and General Internal Medicine, University Hospital Cologne, Cologne, Germany.
3
Department of Nephrology and Hypertension, University Hospital Erlangen, Erlangen, Germany.
4
RJM Group, LLC, Washington, DC, USA.
5
Global Health Economics & Outcomes Research, Sanofi-Aventis US, Cambridge, MA, USA.

Abstract

A health economic analysis was undertaken based on the 1-year database from a randomized study of rabbit anti-human thymocyte immunoglobulin (rATG) versus basiliximab, in kidney transplantation using resource utilization data and cost estimates from three German hospitals. A three-state Markov model was applied to estimate cost-effectiveness to 10 years post-transplant. Total mean treatment cost per patient to year 1 post-transplant was €62 075 vs. €59 767 for rATG versus basiliximab (P < 0.01). rATG therapy was associated with similar treatment costs to basiliximab by year 2, and a predicted cumulative treatment cost saving of €4 259 under rATG versus basiliximab by year 10 post-transplant. The mean number of quality-adjusted life years (QALYs) per patient by year 1 was 0.809 vs. 0.802 in the rATG and basiliximab cohorts, respectively (P = 0.38), with cumulative QALYs of 6.161 and 6.065 per patient by year 10. By year 2, the cumulative cost per QALY was slightly lower under rATG (€35 378) than basiliximab (€35 885), progressing to a saving of €1 041 under rATG for the cumulative cost per QALY by year 10. In conclusion, this model indicates that rATG induction provides a modest increase in QALYs with lower long-term costs than basiliximab in deceased-donor high-risk kidney transplant patients.

KEYWORDS:

anti-human thymocyte immunoglobulin; basiliximab; cost; economic; rabbit anti-human thymocyte immunoglobulin; thymoglobulin

PMID:
28556488
DOI:
10.1111/tri.12991
[Indexed for MEDLINE]
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