Induction therapy with rabbit antithymocyte globulin versus basiliximab after kidney transplantation: a health economic analysis from a German perspective. (24th July 2017)

• Record Type: Journal Article
• Authors: Cremaschi, Liana; von Versen, Regina; Benzing, Thomas; Wiesener, Michael; Zink, Nikolai; Milkovich, Gary; Paivanas, Thomas; Gallagher, Meghan; Thaiss, Friedrich
• Is Part Of: Transplant international. Volume 30:Number 10(2017)
• Page Start: 1011
• Page End: 1019
• Publication Date: 2017-07-24
• Subjects: anti‐human thymocyte immunoglobulin -- basiliximab -- cost -- economic -- rabbit anti‐human thymocyte immunoglobulin -- thymoglobulin; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.12991
• Languages: English
• ISSNs: 0934-0874

Abstract

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 (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.