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A decision‐analytic economic evaluation of valaciclovir prophylaxis for the prevention of cytomegalovirus infection and disease in renal transplantation
Author(s) -
Tilden Dominic P,
Chapman Jeremy,
Davey Peter J,
Solly Michaela L,
Crowley Steven
Publication year - 2004
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2004.00168.x
Subject(s) - medicine , valaciclovir , transplantation , cytomegalovirus infection , cytomegalovirus , disease , intensive care medicine , viral disease , kidney transplantation , immunology , virology , herpesviridae , surgery , virus , human cytomegalovirus
Objective: This analysis evaluates the cost‐effectiveness of valaciclovir prophylaxis using clinically and economically important health outcomes including graft failure, life‐years, and quality‐adjusted life‐years (QALYs). Methods: A Markov model was developed using a randomized, placebo‐controlled trial of valaciclovir prophylaxis, together with a published epidemiological study and national renal transplant registry data. The model's population was stratified into two risk groups by donor/recipient cytomegalovirus (CMV) serostatus at transplantation: donor‐positive/recipient‐negative (D+R−) and recipient‐positive (R+) patients. The model estimated costs and health outcomes over a 30‐yr period from the perspective of Australian health care providers. Results: The total health care cost was $3619 lower for D+R− patients receiving valaciclovir prophylaxis compared with those not receiving prophylaxis. D+R− patients receiving valaciclovir gained an extra 0.33 yr of life and 0.27 QALYs. R+ patients receiving valaciclovir prophylaxis gained an extra 0.07 yr of life and 0.05 QALYs, with an incremental cost of $914. This equates to $17 127 per QALY gained, which is highly cost‐effective compared with other drugs and health interventions. Conclusions: Valaciclovir for the prophylaxis of CMV disease in renal transplant recipients is a cost‐effective intervention, significantly reducing the burden of CMV disease to patients and health care providers.