Cost-effectiveness of modern mTOR inhibitor based immunosuppression compared to the standard of care after renal transplantation in Germany

European Journal of Health Economics

Volumn 16, Issue 4, 2015, Pages 377-390

  Jürgensen, Jan Steffen ^a,b   Ikenberg, Robert ^c   Greiner, Roger Axel ^c   Hösel, Volker ^d  

^a CHARITÉ UNIVERSITÄTSMEDIZIN BERLIN   (Germany)

^b FOM UNIVERSITY OF APPLIED SCIENCES   (Germany)

^c IQVIA   (United States)

^d StatSciConsult   (Germany)

Author keywords

Cost effectiveness; Germany; Immunosuppressive regimens; Mixed treatment comparison; Modelling; Renal transplant; Sirolimus

Indexed keywords

CYCLOSPORIN; EVEROLIMUS; IMMUNOSUPPRESSIVE AGENT; MYCOPHENOLATE MOFETIL; MYCOPHENOLIC ACID; RAPAMYCIN;

ANALOGS AND DERIVATIVES; COMPARATIVE STUDY; COST BENEFIT ANALYSIS; DRUG ADMINISTRATION; DRUG COST; ECONOMICS; EPIDEMIOLOGY; GERMANY; GRAFT REJECTION; HEALTH CARE COST; HUMAN; KIDNEY TRANSPLANTATION; MARKOV CHAIN; PROCEDURES; STATISTICS AND NUMERICAL DATA;

COST-BENEFIT ANALYSIS; CYCLOSPORINE; DRUG ADMINISTRATION SCHEDULE; DRUG COSTS; EVEROLIMUS; GERMANY; GRAFT REJECTION; HEALTH CARE COSTS; HUMANS; IMMUNOSUPPRESSIVE AGENTS; KIDNEY TRANSPLANTATION; MARKOV CHAINS; MYCOPHENOLIC ACID; SIROLIMUS;

EID: 84939877214     PISSN: 16187598     EISSN: 16187601     Source Type: Journal    
DOI: 10.1007/s10198-014-0579-3     Document Type: Article

References (46)

1. Fiebiger, W., Mitterbauer, C., Oberbauer, R.: Health-related quality of life outcomes after kidney transplantation. Health Qual. Life Outcomes 8(2), 2 (2004)
2. Joseph, J.T., Baines, L.S., Morris, M.C., Jindal, R.M.: Quality of life after kidney and pancreas transplantation: a review. Am. J. Kidney Dis. 42(3), 431–445 (2003)
3. Nagel, E., Niechzial, M.: Bewertung chirurgischer Therapien. Angemessenheit-Notwendigkeit-Zweckmäßigkeit., pp. 113–128. Springer, Berlin (1999)
4. Winkelmayer, W.C., Weinstein, M.C., Mittleman, M.A., Glynn, R.J., Pliskin, J.S.: Health economic evaluations: the special case of end-stage renal disease treatment. Med. Decis. Making 22, 417–430 (2002)
5. Wolfe, R.A., Ashby, V.B., Milford, E.L., Ojo, A.O., Ettenger, R.E., Agodoa, L.Y., Held, P.J., Port, F.K.: Comparison of mortality in all patients on dialysis, patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N. Engl. J. Med. 341, 1725–1730 (1999)
6. Hagenmeyer, E.G., Haussler, B., Hempel, E., Grannas, G., Kaló, Z., Kilburg, A., Nashan, B.: Resource use and treatment costs after kidney transplantation: impact of demographic factors, comorbidities, and complications. Transplantation 77, 1545–1550 (2004)
7. Jürgensen, J.S., Arns, W., Hass, B.: Cost-effectiveness of immunosuppressive regimens in renal transplant recipients in Germany: a model approach. Eur. J. Health Econ. 11(1), 15–25 (2010)
8. Johnson, R., Kreis, H., Oberbauer, R., Brattström, C., Claesson, K., Eris, J.: Sirolimus allows early cyclosporine withdrawal in renal transplantation resulting in improved renal function and lower blood pressure. Transplantation 72(5), 774–775 (2001)
9. Oberbauer, R., Kreis, H., Johnson, R.W., Mota, A., Claesson, K., Ruiz, J.C., Wilczek, H., Jamieson, N., Henriques, A.C., Paczek, L., Chapman, J., Burke, J.T.: Long-term improvement in renal function with sirolimus after early cyclosporine withdrawal in renal transplant recipients: 2-year results of the rapamune maintenance regimen study. Transplantation 76(2), 364–370 (2003)
10. Campistol, J.M., Eris, J., Oberbauer, R., Friend, P., Hutchison, B., Morales, J.M., Claesson, K., Stallone, G., Russ, G., Rostaing, L., Kreis, H., Burke, J.T., Brault, Y., Scarola, J.A., Neylan, J.F.: Sirolimus therapy after early cyclosporine withdrawal reduces the risk for cancer in adult renal transplantation. J. Am. Soc. Nephrol. 17, 581–589 (2006)
11. Lebranchu, Y., Thierry, A., Toupance, O., Westeel, P.F., Etienne, I., Thervet, E., Moulin, B., Frouget, T., Le Meur, Y., Glotz, D., Heng, A.E., Onno, C., Buchler, M., Girardot-Seguin, S., Hurault de Ligny, B.: Efficacy on renal function of early conversion from cyclosporine to sirolimus 3 months after renal transplantation: concept study. Am. J. Transplant. 9, 1115–1123 (2009)
12. Lebranchu, Y., Thierry, A., Thervet, E., Büchler, M., Etienne, I., Westeel, P.F., Hurault de Ligny, B., Moulin, B., Rérolle, J.P., Frouget, T., Girardot-Seguin, S., Toupance, O.: Efficacy and safety of early cyclosporine conversion to sirolimus with continued MMF-four-year results of the Postconcept study. Am. J. Transplant. 11(8), 1665–1675 (2011)
13. Guba, M., Pratschke, J., Hugo, C., Krämer, B.K., Nohr-Westphal, C., Brockmann, J., Andrassy, J., Reinke, P., Pressmar, K., Hakenberg, O., Fischereder, M., Pascher, A., Illner, W.D., Banas, B., Jauch, K.W.: Renal function, efficacy, and safety of sirolimus and mycophenolate mofetil after short-term calcineurin inhibitor-based quadruple therapy in de novo renal transplant patients: one-year analysis of a randomized multicenter trial. Transplantation 90(2), 175–183 (2010)
14. Guba, M., Pratschke, J., Hugo, C., Krämer, B.K., Pascher, A., Pressmar, K., Hakenberg, O., Fischereder, M., Brockmann, J., Andrassy, J., Banas, B., Jauch, K.W.: Early conversion to a sirolimus-based, calcineurin-inhibitor-free immunosuppression in the SMART trial: observational results at 24 and 36 months after transplantation. Transpl. Int. 25(4), 416–423 (2012)
15. Weir, M., Mulgaonkar, S., Chan, L., Shidban, H., Waid, T.H., Preston, D., Kalil, R.N., Pearson, T.C.: Mycophenolate mofetil-based immunosuppression with sirolimus in renal transplantation: a randomized, controlled spare-the-nephron trial. Kidney Int. 79(8), 897–907 (2011)
16. Budde, K., Becker, T., Arns, W., Sommerer, C., Reinke, P., Eisenberger, U., Kramer, S., Fischer, W., Gschaidmeier, H., Pietruck, F.: Everolimus-based, calcineurin-inhibitor-free regimen in recipients of de-novo kidney transplants: an open-label, randomised, controlled trial. Lancet 377(9768), 837–847 (2011)
17. Ekberg, H., Tedesco-Silva, H., Demirbas, A., Vítko, S., Nashan, B., Gürkan, A., Margreiter, R., Hugo, C., Grinyó, J.M., Frei, U., Vanrenterghem, Y., Daloze, P., Halloran, P.F.: Reduced exposure to calcineurin inhibitors in renal transplantation. N. Engl. J. Med. 357, 2562–2575 (2007)
18. Ekberg, H., Bernasconi, C., Tedesco-Silva, H., Vítko, S., Hugo, C., Demirbas, A., Acevedo, R.R., Grinyó, J., Frei, U., Vanrenterghem, Y., Daloze, P., Halloran, P.: Calcineurin inhibitor minimization in the Symphony study: observational results 3 years after transplantation. Am. J. Transplant. 9, 1–10 (2009)
19. Glenny, A.M., Altman, D.G., Song, F., Sakarovitch, C., Deeks, J.J., D’Amico, R., Bradburn, M., Eastwood, A.J.: Indirect comparisons of competing interventions. Health Technol. Assess. 9, 1–134 (2005)
20. Bucher, H.C., Guyatt, G.H., Griffith, L.E., Walter, S.D.: The results of direct and indirect treatment comparisons in meta-analysis of randomized controlled trials. J. Clin. Epidemiol. 50(6), 683–691 (1997)
21. Salanti, G., Higgins, J., Ades, A.E., Ioannidis, J.P.: Evaluation of networks of randomized trials. Stat. Methods Med. Res. 17(3), 279–301 (2008)
22. Song, F., Loke, YK., Walsh, T., Glenny, A.M., Eastwood, A.J., Altman, D.G.: Methodological problems in the use of indirect comparisons for evaluating healthcare interventions: survey of published systematic reviews. BMJ 338:b1147
23. Jansen, J.P., Crawford, B., Bergman, G., Stam, W.: Bayesian meta-analysis of multiple treatment comparisons: an introduction to treatment comparisons. Value Health 11(5), 956–964 (2008)
24. WinBUGS. The Bugs Project. http://www.mrc-bsu.cam.ac.uk/bugs/winbugs/contents.shtml. Accessed 30 Aug 2011
25. McEwan, P., Dixon, S., Baboolal, K., Conway, P., Currie, C.J.: Evaluation of the cost effectiveness of sirolimus versus tacrolimus for immunosuppression following renal transplantation in the UK. Pharmacoeconomics 24(1), 67–79 (2006)
26. Vincenti, F.: What’s in the pipeline? New immunosuppressive drugs in transplantation. Am. J. Transplant. 2(10), 898–903 (2002)
27. Vanrenterghem, Y., Ponticelli, C., Morales, J.M., Abramowicz, D., Baboolal, K., Eklund, B., Kliem, V., Legendre, C., Morais Sarmento, A.L., Vincenti, F.: Prevalence and management of anemia in renal transplant recipients: a European survey. Am. J. Transplant. 3(7), 835–845 (2003)
28. Miller, D.K., Homan, S.M.: Determining transition probabilities: confusion and suggestions. Med. Decis. Making 14(1), 52–58 (1994)
29. ® LAUER-Taxe. Accessed 29 Mar 2012
30. Kauffman, H.M.: Malignancies in organ transplant recipients. J. Surg. Oncol. 94(5), 431–433 (2006)
31. InEK (2011) G-DRG Report-Browser 2009/2011 Institut für das Entgeltsystem im Krankenhaus GmbH (InEK). Fallpauschalen-Katalog 2011. http://www.g-drg.de. Accessed 24 Nov 2011
32. Kupsch, S., Kern, AO., Hallauer, JF.: Versorgung von Patienten mit Nierenersatztherapie in Deutschland: Epidemiologische, medizinische und ökonomische Aspekte von Dialyse und Transplantation. Kiel Institut für Gesundheits-System-Forschung, Kiel. 161–171 (1998)
33. Frei, U., Schober-Halstenberg, HJ.: Nierenersatztherapie in Deutschland. Bericht über Dialysebehandlung und Nierentransplantation in Deutschland 2005/2006. http://www.quasi-niere.de/download/berichte/de/QuaSi-Niere-Bericht_2005-2006.pdf (2006). Accessed 5 Nov 2011
34. Statistisches Bundesamt. http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Statistiken/Zeitreihen/WirtschaftAktuell/Basisdaten/Content100/vpi101a.psml (2011). Accessed 5 Nov 2011
35. Kaelble, T., Lucan, M., Nicita, G., Sells, R., Burgos Revilla, F.J., Wiesel, M.: EAU guidelines on renal transplantation. Eur. Urol. 47(2), 156–166 (2005) http://www.uroweb.org/fileadmin/user_upload/Guidelines/23%20Renal%20Transplant.pdf. Accessed 5 Nov 2011
36. Köster, I., Huppertz, E., Hauner, H., Schubert, I.: Direct costs of diabetes mellitus in Germany—CoDiM 2000–2007. Exp. Clin. Endocrinol. Diabetes 119(6), 377–385 (2011)
37. Evans, M., Hastings, N., Peacock, B.: Triangular distribution. In: Statistical Distributions, pp.187–188. Wiley, New York (2000)
38. Briggs, A.H., Weinstein, M.C., Fenwick, E.A., Karnon, J., Sculpher, M.J., Paltiel, A.D.: ISPOR-SMDM Modeling Good Research Practices Task Force. Model parameter estimation and uncertainty: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force–6. Value Health 15(6), 835–842 (2012)
39. Kahan, B.D.: Efficacy of sirolimus compared with azathioprine for reduction of acute renal allograft rejection: a randomised multicentre study. The Rapamune US Study Group. Lancet 356(9225), 194–202 (2000)
40. Groth, C.G., Bäckman, L., Morales, J.M., Calne, R., Kreis, H., Lang, P., Touraine, J.L., Claesson, K., Campistol, J.M., Durand, D., Wramner, L., Brattström, C., Charpentier, B.: Sirolimus (rapamycin)-based therapy in human renal transplantation: similar efficacy and different toxicity compared with cyclosporine. Sirolimus European Renal Transplant Study Group. Transplantation 67(7), 1036–1042 (1999)
41. Kreis, H., Cisterne, J.M., Land, W., Wramner, L., Squifflet, J.P., Abramowicz, D., Campistol, J.M., Morales, J.M., Grinyo, J.M., Mourad, G., Berthoux, F.C., Brattström, C., Lebranchu, Y., Vialtel, P.: Sirolimus in association with mycophenolate mofetil induction for the prevention of acute graft rejection in renal allograft recipients. Transplantation 69(7), 1252–1260 (2000)
42. Flechner, S.M., Goldfarb, D., Modlin, C., Feng, J., Krishnamurthi, V., Mastroianni, B., Savas, K., Cook, D.J., Novick, A.C.: Kidney transplantation without calcineurin inhibitor drugs: a prospective, randomized trial of sirolimus versus cyclosporine. Transplantation 74(8), 1070–1076 (2002)
43. Earnshaw, S.R., Graham, C.N., Irish, W.D., Sato, R., Schnitzler, M.A.: Lifetime cost-effectiveness of calcineurin inhibitor withdrawal after de novo renal transplantation. J. Am. Soc. Nephrol. 19(9), 1807–1816 (2008)
44. Naderi, M., Aslani, J., Hashemi, M., Assari, S., Amini, M., Pourfarziani, V.: Prolonged rehospitalizations following renal transplantation: causes, risk factors, and outcomes. Transplant. Proc. 39, 978–980 (2007)
45. Zeller, W.J.: Immuntherapeutika und Zytostatika. In: Schwabe, U., Paffrath, D. (eds.) Arzneiverordnungs-Report 2006. Aktuelle Daten Kosten, Trends und Kommentare, pp. 664–677. Springer, Berlin (2007)
46. Nankivell, B.J., Borrows, R.J., Fung, C.L., O’Connell, P.J., Allen, R.D., Chapman, J.R.: The natural history of chronic allograft nephropathy. N. Engl. J. Med. 349(24), 2326–2333 (2003)