Induction therapy with rabbit antithymocyte globulin versus basiliximab after kidney transplantation: a health economic analysis from a German perspective

Transpl Int. 2017 Oct;30(10):1011-1019. doi: 10.1111/tri.12991. Epub 2017 Jul 24.

Abstract

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.

Keywords: anti-human thymocyte immunoglobulin; basiliximab; cost; economic; rabbit anti-human thymocyte immunoglobulin; thymoglobulin.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Animals
  • Antibodies, Monoclonal / economics*
  • Antilymphocyte Serum / economics*
  • Basiliximab
  • Humans
  • Immunosuppressive Agents / economics*
  • Induction Chemotherapy / economics
  • Kidney Transplantation / economics*
  • Middle Aged
  • Quality-Adjusted Life Years
  • Rabbits
  • Recombinant Fusion Proteins / economics*

Substances

  • Antibodies, Monoclonal
  • Antilymphocyte Serum
  • Immunosuppressive Agents
  • Recombinant Fusion Proteins
  • Basiliximab
  • thymoglobulin