Economic evaluation of everolimus vs. azathioprine at one year after de novo heart transplantation

Jasmina I. Radeva, Shelby D. Reed, Z. Kaló, Teresa L. Kauf, Edward Cantu, Nathalie Cretin, Kevin A. Schulman

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Everolimus decreases acute rejection and cardiac allograft vasculopathy after heart transplantation. We compared within-trial costs and resource use over 1 yr of follow-up in de novo heart transplant patients randomized to everolimus 1.5 mg/d (n = 209), everolimus 3.0 mg/d (n = 211), or azathioprine (n = 214). Patients and methods: Resource use data were collected prospectively for 634 patients from 14 countries. We used the nonparametric bootstrap method to test for differences in mean costs and to estimate confidence intervals for cost-effectiveness ratios. Results: Everolimus patients had lower incidence of efficacy failure compared with azathioprine patients (41.6%, everolimus 1.5 mg; 32.2%, everolimus 3.0 mg; 52.8%, azathioprine). Compared with patients receiving azathioprine, everolimus patients spent more days in the hospital [36.3 d for everolimus 1.5 mg/d (p = 0.21); 38.4 d for everolimus 3.0 mg/d (p = 0.01); 32.2 d for azathioprine]. Mean total costs, excluding the study medications, were not significantly different among treatment groups ($72 065 for everolimus 1.5 mg; $72 631 for everolimus 3.0 mg; $70 815 for azathioprine). Conclusions: Over 1 yr of follow-up after heart transplantation, everolimus did not significantly increase treatment costs, excluding the costs of the study medications, while reducing efficacy failure. Longer follow-up and the cost of everolimus are required to fully evaluate the cost-effectiveness of everolimus vs. azathioprine in post-transplant maintenance.

Original languageEnglish
Pages (from-to)122-129
Number of pages8
JournalClinical Transplantation
Volume19
Issue number1
DOIs
Publication statusPublished - Feb 2005

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Azathioprine
Heart Transplantation
Cost-Benefit Analysis
Costs and Cost Analysis
Everolimus
Transplants
Health Care Costs
Allografts

Keywords

  • Graft rejection
  • Heart transplantation
  • Immunosuppresion
  • Immunosuppresive agents
  • Infection

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Economic evaluation of everolimus vs. azathioprine at one year after de novo heart transplantation. / Radeva, Jasmina I.; Reed, Shelby D.; Kaló, Z.; Kauf, Teresa L.; Cantu, Edward; Cretin, Nathalie; Schulman, Kevin A.

In: Clinical Transplantation, Vol. 19, No. 1, 02.2005, p. 122-129.

Research output: Contribution to journalArticle

Radeva, Jasmina I. ; Reed, Shelby D. ; Kaló, Z. ; Kauf, Teresa L. ; Cantu, Edward ; Cretin, Nathalie ; Schulman, Kevin A. / Economic evaluation of everolimus vs. azathioprine at one year after de novo heart transplantation. In: Clinical Transplantation. 2005 ; Vol. 19, No. 1. pp. 122-129.
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abstract = "Background: Everolimus decreases acute rejection and cardiac allograft vasculopathy after heart transplantation. We compared within-trial costs and resource use over 1 yr of follow-up in de novo heart transplant patients randomized to everolimus 1.5 mg/d (n = 209), everolimus 3.0 mg/d (n = 211), or azathioprine (n = 214). Patients and methods: Resource use data were collected prospectively for 634 patients from 14 countries. We used the nonparametric bootstrap method to test for differences in mean costs and to estimate confidence intervals for cost-effectiveness ratios. Results: Everolimus patients had lower incidence of efficacy failure compared with azathioprine patients (41.6{\%}, everolimus 1.5 mg; 32.2{\%}, everolimus 3.0 mg; 52.8{\%}, azathioprine). Compared with patients receiving azathioprine, everolimus patients spent more days in the hospital [36.3 d for everolimus 1.5 mg/d (p = 0.21); 38.4 d for everolimus 3.0 mg/d (p = 0.01); 32.2 d for azathioprine]. Mean total costs, excluding the study medications, were not significantly different among treatment groups ($72 065 for everolimus 1.5 mg; $72 631 for everolimus 3.0 mg; $70 815 for azathioprine). Conclusions: Over 1 yr of follow-up after heart transplantation, everolimus did not significantly increase treatment costs, excluding the costs of the study medications, while reducing efficacy failure. Longer follow-up and the cost of everolimus are required to fully evaluate the cost-effectiveness of everolimus vs. azathioprine in post-transplant maintenance.",
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T1 - Economic evaluation of everolimus vs. azathioprine at one year after de novo heart transplantation

AU - Radeva, Jasmina I.

AU - Reed, Shelby D.

AU - Kaló, Z.

AU - Kauf, Teresa L.

AU - Cantu, Edward

AU - Cretin, Nathalie

AU - Schulman, Kevin A.

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N2 - Background: Everolimus decreases acute rejection and cardiac allograft vasculopathy after heart transplantation. We compared within-trial costs and resource use over 1 yr of follow-up in de novo heart transplant patients randomized to everolimus 1.5 mg/d (n = 209), everolimus 3.0 mg/d (n = 211), or azathioprine (n = 214). Patients and methods: Resource use data were collected prospectively for 634 patients from 14 countries. We used the nonparametric bootstrap method to test for differences in mean costs and to estimate confidence intervals for cost-effectiveness ratios. Results: Everolimus patients had lower incidence of efficacy failure compared with azathioprine patients (41.6%, everolimus 1.5 mg; 32.2%, everolimus 3.0 mg; 52.8%, azathioprine). Compared with patients receiving azathioprine, everolimus patients spent more days in the hospital [36.3 d for everolimus 1.5 mg/d (p = 0.21); 38.4 d for everolimus 3.0 mg/d (p = 0.01); 32.2 d for azathioprine]. Mean total costs, excluding the study medications, were not significantly different among treatment groups ($72 065 for everolimus 1.5 mg; $72 631 for everolimus 3.0 mg; $70 815 for azathioprine). Conclusions: Over 1 yr of follow-up after heart transplantation, everolimus did not significantly increase treatment costs, excluding the costs of the study medications, while reducing efficacy failure. Longer follow-up and the cost of everolimus are required to fully evaluate the cost-effectiveness of everolimus vs. azathioprine in post-transplant maintenance.

AB - Background: Everolimus decreases acute rejection and cardiac allograft vasculopathy after heart transplantation. We compared within-trial costs and resource use over 1 yr of follow-up in de novo heart transplant patients randomized to everolimus 1.5 mg/d (n = 209), everolimus 3.0 mg/d (n = 211), or azathioprine (n = 214). Patients and methods: Resource use data were collected prospectively for 634 patients from 14 countries. We used the nonparametric bootstrap method to test for differences in mean costs and to estimate confidence intervals for cost-effectiveness ratios. Results: Everolimus patients had lower incidence of efficacy failure compared with azathioprine patients (41.6%, everolimus 1.5 mg; 32.2%, everolimus 3.0 mg; 52.8%, azathioprine). Compared with patients receiving azathioprine, everolimus patients spent more days in the hospital [36.3 d for everolimus 1.5 mg/d (p = 0.21); 38.4 d for everolimus 3.0 mg/d (p = 0.01); 32.2 d for azathioprine]. Mean total costs, excluding the study medications, were not significantly different among treatment groups ($72 065 for everolimus 1.5 mg; $72 631 for everolimus 3.0 mg; $70 815 for azathioprine). Conclusions: Over 1 yr of follow-up after heart transplantation, everolimus did not significantly increase treatment costs, excluding the costs of the study medications, while reducing efficacy failure. Longer follow-up and the cost of everolimus are required to fully evaluate the cost-effectiveness of everolimus vs. azathioprine in post-transplant maintenance.

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KW - Immunosuppresion

KW - Immunosuppresive agents

KW - Infection

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