OBJECTIVE: To evaluate the economic implications for transplant centres, Medicare and society of treatment of corticosteroid-resistant Banff Grades I, II and III acute kidney transplant rejection with the antithymocyte globulins Thymoglobulin or Atgam. DESIGN AND SETTING: This was a cost analysis of a randomised double-blind multicentre clinical trial comparing the safety and efficacy of Thymoglobulin and Atgam that was performed at 25 centres in the US in 1994 to 1996. PATIENTS AND PARTICIPANTS: The study enrolled 163 patients, 82 in the Thymoglobulin arm and 81 in the Atgam arm. METHODS: Estimates of the cost of care from the initiation of rejection therapy to 90 days post-therapy were derived from various publicly available sources and applied to patient-specific clinical events documented in the clinical trial. Patients received either intravenous Thymoglobulin (1.5 mg/kg/day) for an average of 10 days or intravenous Atgam (15 mg/kg/day) for an average of 9.7 days. RESULTS: On average, Thymoglobulin provided significant cost savings compared with Atgam from the perspective of society [$US5977 (1996 values); 95% confidence interval (CI) $US3719 to $US8254], Medicare ($US4967; 95% CI $US3256 to $US6678) and the transplant centre ($US3087; 95% CI $US1512 to $US4667). The overall advantage attributable to Thymoglobulin was primarily due to savings from fewer recurrent rejection treatments and less frequent return to dialysis. CONCLUSIONS: Treatment of acute renal transplant rejection withThymoglobulin is a cost saving strategy when compared with treatment with Atgam.
RCT Entities:
OBJECTIVE: To evaluate the economic implications for transplant centres, Medicare and society of treatment of corticosteroid-resistant Banff Grades I, II and III acute kidney transplant rejection with the antithymocyte globulins Thymoglobulin or Atgam. DESIGN AND SETTING: This was a cost analysis of a randomised double-blind multicentre clinical trial comparing the safety and efficacy of Thymoglobulin and Atgam that was performed at 25 centres in the US in 1994 to 1996. PATIENTS AND PARTICIPANTS: The study enrolled 163 patients, 82 in the Thymoglobulin arm and 81 in the Atgam arm. METHODS: Estimates of the cost of care from the initiation of rejection therapy to 90 days post-therapy were derived from various publicly available sources and applied to patient-specific clinical events documented in the clinical trial. Patients received either intravenous Thymoglobulin (1.5 mg/kg/day) for an average of 10 days or intravenous Atgam (15 mg/kg/day) for an average of 9.7 days. RESULTS: On average, Thymoglobulin provided significant cost savings compared with Atgam from the perspective of society [$US5977 (1996 values); 95% confidence interval (CI) $US3719 to $US8254], Medicare ($US4967; 95% CI $US3256 to $US6678) and the transplant centre ($US3087; 95% CI $US1512 to $US4667). The overall advantage attributable to Thymoglobulin was primarily due to savings from fewer recurrent rejection treatments and less frequent return to dialysis. CONCLUSIONS: Treatment of acute renal transplant rejection with Thymoglobulin is a cost saving strategy when compared with treatment with Atgam.
Authors: D J O'Donoghue; R W Johnson; N P Mallick; R Gokal; F W Ballardie; A Bakran; R Pearson; P Scott Journal: Transplant Proc Date: 1989-02 Impact factor: 1.066
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Authors: K Solez; R A Axelsen; H Benediktsson; J F Burdick; A H Cohen; R B Colvin; B P Croker; D Droz; M S Dunnill; P F Halloran Journal: Kidney Int Date: 1993-08 Impact factor: 10.612
Authors: A O Gaber; M R First; R J Tesi; R S Gaston; R Mendez; L L Mulloy; J A Light; L W Gaber; E Squiers; R J Taylor; J F Neylan; R W Steiner; S Knechtle; D J Norman; F Shihab; G Basadonna; D C Brennan; E E Hodge; B D Kahan; L Kahan; S Steinberg; E S Woodle; L Chan; J M Ham; T J Schroeder Journal: Transplantation Date: 1998-07-15 Impact factor: 4.939
Authors: Joseph Menzin; Lisa M Lines; Daniel E Weiner; Peter J Neumann; Christine Nichols; Lauren Rodriguez; Irene Agodoa; Tracy Mayne Journal: Pharmacoeconomics Date: 2011-10 Impact factor: 4.981