Economic impacts of alternative kidney transplant immunosuppression: A national cohort study.
In: Clinical transplantation, Jg. 34 (2020-04-01), Heft 4, S. e13813
Online
academicJournal
Zugriff:
Understanding the economic implications of induction and maintenance immunosuppression (ISx) is important in developing personalized kidney transplant (KTx) care. Using data from a novel integrated data set including financial records from the University Health System Consortium, Medicare, and pharmacy claims (2007-2014), we estimated the differences in the impact of induction and maintenance ISx regimens on transplant hospitalization costs and Medicare payments from KTx to 3 years. Use of thymoglobulin (TMG) significantly increased transplant hospitalization costs ($12 006; P = .02), compared with alemtuzumab and basiliximab. TMG resulted in lower Medicare payments in posttransplant years 1 (-$2058; P = .05) and 2 (-$1784; P = .048). Patients on steroid-sparing ISx incurred relatively lower total Medicare spending (-$10 880; P = .01) compared with patients on triple therapy (tacrolimus, antimetabolite, and steroids). MPA/AZA-sparing, mammalian target of rapamycin inhibitors-based, and cyclosporine-based maintenance ISx regimens were associated with significantly higher payments. Alternative ISx regimens were associated with different KTx hospitalization costs and longer-term payments. Future studies of clinical efficacy should also consider cost impacts to define the economic effectiveness of alternative ISx regimens.
(© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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Economic impacts of alternative kidney transplant immunosuppression: A national cohort study.
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Autor/in / Beteiligte Person: | Axelrod, DA ; Caliskan, Y ; Schnitzler, MA ; Xiao, H ; Dharnidharka, VR ; Segev, DL ; McAdams-DeMarco, M ; Brennan, DC ; Randall, H ; Alhamad, T ; Kasiske, BL ; Hess, G ; Lentine, KL |
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Zeitschrift: | Clinical transplantation, Jg. 34 (2020-04-01), Heft 4, S. e13813 |
Veröffentlichung: | Copenhagen : Munksgaard,, 2020 |
Medientyp: | academicJournal |
ISSN: | 1399-0012 (electronic) |
DOI: | 10.1111/ctr.13813 |
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