Cost-effectiveness analysis of immunosuppressive drugs in post-renal transplantation maintenance therapy in adult patients in Brazil

被引：1

作者：

Acurcio, Francisco de Assis ^{[1
]}

Mattana Saturnino, Luciana Tarbes ^{[2
]}

da Silva, Anderson Lourenco ^{[3
]}

Araujo de Oliveira, Gustavo Laine ^{[1
]}

Gurgel Andrade, Eli Iola ^{[4
]}

Cherchiglia, Mariangela Leal ^{[4
]}

Braga Ceccato, Maria das Gracas ^{[1
]}

机构：

[1] Univ Fed Minas Gerais, Fac Farm, BR-31270010 Belo Horizonte, MG, Brazil

[2] Univ Fed Sao Joao Del Rei, Fac Farm, Divinopolis, Brazil

[3] Secretaria Estadual Saude Rio de Janeiro, Rio De Janeiro, Brazil

[4] Univ Fed Minas Gerais, Fac Med, BR-31270010 Belo Horizonte, MG, Brazil

来源：

CADERNOS DE SAUDE PUBLICA | 2013年 / 29卷

关键词：

Immunosuppressive Agents; Kidney Transplantation; Cost-Effectiveness Evaluation; Health Technology Assessment; RENAL-TRANSPLANTATION; RANDOMIZED-TRIAL; KIDNEY-TRANSPLANTATION; MYCOPHENOLATE-MOFETIL; TACROLIMUS; CYCLOSPORINE; SIROLIMUS; RECIPIENTS; REJECTION; EFFICACY;

D O I：

10.1590/0102-311X00006913

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

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 (Camara de Regulacao 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%.

引用

页码：S92 / S109

页数：18

共 37 条

[1]

Alvares J, 2011, QUAL LIFE RES, V20, P111

[2]

[Anonymous], Anatomical Therapeutic Chemical (ATC) Classification

[3]

[Anonymous], 2006, Decision modelling for health economic evaluation

[4]

[Anonymous], COST EFF THRESH

[5]

Associacao Brasileira de Transplantes de Orgaos, 2007, REG BRAS TRANSPL 10

[6]

Ben Hamida F, 2009, SAUDI J KIDNEY DIS T, V20, P370

[7]

Camara de Regulacao do Mercado de Medicamentos, PREC MAX MED MON PRI

[8] Exceptional circumstance drug dispensing: history and expenditures of the Brazilian Ministry of Health [J].

Carias, Claudia Mezleveckas ;

Vieira, Fabiola Sulpino ;

Giordano, Carlos V. ;

Zucchi, Paola .

REVISTA DE SAUDE PUBLICA, 2011, 45 (02) :233-240

[9] Determinants of expenditures on dialysis in the Unified National Health System, Brazil, 2000 to 2004 [J].

Cherchiglia, Mariangela Leal ;

Gomes, Isabel Cristina ;

Alvares, Juliana ;

Guerra Junior, Augusto ;

Acurcio, Francisco de Assis ;

Gurgel Andrade, Eli Iola ;

Almeida, Alessandra Maciel ;

Campo Szuster, Daniele Araujo ;

Andrade, Monica Viegas ;

de Queiroz, Odilon Vanni .

CADERNOS DE SAUDE PUBLICA, 2010, 26 (08) :1627-1641

[10]

Departamento de Ciencia e Tecnologia Secretaria de Ciencia Tecnologia e Insumos Estrategicos Ministerio da Saude, 2009, DIR MET EST AV EC TE

← 1 2 3 4 →