Open AccessInduction therapy with rabbit antithymocyte globulin versus basiliximab after kidney transplantation: a health economic analysis from a German perspective
Author(s) -
Cremaschi Liana,
Versen Regina,
Benzing Thomas,
Wiesener Michael,
Zink Nikolai,
Milkovich Gary,
Paivanas Thomas,
Gallagher Meghan,
Thaiss Friedrich
Publication year - 2017
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12991
Subject(s) - basiliximab , medicine , transplantation , discontinuation , kidney transplantation , cumulative incidence , anti thymocyte globulin , urology
Summary 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 ( QALY s) per patient by year 1 was 0.809 vs. 0.802 in the rATG and basiliximab cohorts, respectively ( P = 0.38), with cumulative QALY s 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 QALY s with lower long‐term costs than basiliximab in deceased‐donor high‐risk kidney transplant patients.