Cyclosporine versus tacrolimus: cost-effectiveness analysis for renal transplantation in Brazil

被引:5
作者
Guerra Junior, Augusto Afonso [1 ,3 ]
Silva, Grazielle Dias [2 ]
Gurgel Andrade, Eli Iola [1 ]
Cherchiglia, Mariangela Leal [1 ]
Costa, Juliana de Oliveira [3 ]
Almeida, Alessandra Maciel [1 ]
Acurcio, Francisco de Assis [1 ,3 ]
机构
[1] Univ Fed Minas Gerais, Fac Med, Dept Med Prevent & Social, BR-31270901 Belo Horizonte, MG, Brazil
[2] Secretaria Estado Saude Minas Gerais, Superintendencia Assistencia Farmaceut, Belo Horizonte, MG, Brazil
[3] Univ Fed Minas Gerais, Fac Farm, Dept Farm Social, Ave Presidente Antonio Carlos,6627 Campus Pampulh, BR-31270901 Belo Horizonte, MG, Brazil
来源
REVISTA DE SAUDE PUBLICA | 2015年 / 49卷
关键词
Immunosuppressive Agents; therapeutic use; Kidney Transplantation; economics; Graft Survival; Transplantation Tolerance; drug effects; Cost-Benefit Analysis; Unified Health System; Cohort Studies; GRAFT-SURVIVAL; IMMUNOSUPPRESSIVE REGIMENS; OUTCOMES; MICROEMULSION; EFFICACY; RECIPIENTS; SAFETY; MODEL;
D O I
10.1590/S0034-8910.2015049005430
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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. However, regimens containing cyclosporine were more cost-effective.
引用
收藏
页数:9
相关论文
共 25 条
[1]   Graft survival following living-donor renal transplantation: A comparison of tacrolimus and cyclosporine microemulsion with mycophenolate mofetil and steroids [J].
Bunnapradist, S ;
Daswani, A ;
Takemoto, SK .
TRANSPLANTATION, 2003, 76 (01) :10-15
[2]   Epidemiological profile of patients on renal replacement therapy in Brazil, 2000-2004 [J].
Cherchiglia, Mariangela Leal ;
Machado, Elaine Leandro ;
Campo Szuster, Daniele Araujo ;
Gurgel Andrade, Eli Iola ;
Acurcio, Francisco de Assis ;
Caiaffa, Waleska Teixeira ;
Sesso, Ricardo ;
Guerra, Augusto A., Jr. ;
de Queiroz, Odilon Vanni ;
Gomes, Isabel Cristina .
REVISTA DE SAUDE PUBLICA, 2010, 44 (04) :639-649
[3]  
Cherchiglia Mariângela Leal, 2007, Rev. bras. estud. popul., V24, P163
[4]  
de Queiroz OV, 2009, EPIDEMIOL SERV SAUDE, V18, P107
[5]  
Fauci AS, 2008, HARRISON MED INTERNA, P2008
[6]  
Filho M A., 1997, Medicina, V19, P215
[7]  
GAIL MH, 2000, ENCY EPIDEMIOLOGIC M, P669
[8]   Tacrolimus-Basiliximab versus cyclosporine-basiliximab in renal transplantation "De novo": Acute rejection and complications [J].
Garcia, DM ;
Gago, JM ;
Mendiluce, A ;
Gordillo, R ;
Bustamente, J .
TRANSPLANTATION PROCEEDINGS, 2003, 35 (05) :1694-1696
[9]   Impact of the new drugs in the cost of maintenance immunosuppression of renal transplantation.: Is it justified? [J].
Gentil, MA ;
Aixendri, CC ;
Roncero, FMG ;
Franco, JEM ;
Martínez, MLD .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2004, 19 :77-82
[10]   Disparities in Kidney Transplant Outcomes: A Review [J].
Gordon, Elisa J. ;
Ladner, Daniela P. ;
Caicedo, Juan Carlos ;
Franklin, John .
SEMINARS IN NEPHROLOGY, 2010, 30 (01) :81-89