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Foroutan N, Rasekh HR, Salamzadeh J, et al. Budget impact analysis of conversion from cyclosporine to sirolimus as immunosuppressive medication in renal transplantation therapy. Clinicoecon Outcomes Res. 2013;5:545-53doi: 10.2147/CEOR.S51446.
Foroutan, N., Rasekh, H. R., Salamzadeh, J., Jamshidi, H. R., & Nafar, M. (2013). Budget impact analysis of conversion from cyclosporine to sirolimus as immunosuppressive medication in renal transplantation therapy. ClinicoEconomics and outcomes research : CEOR, 5545-53. https://doi.org/10.2147/CEOR.S51446
Foroutan, Naghmeh, et al. "Budget impact analysis of conversion from cyclosporine to sirolimus as immunosuppressive medication in renal transplantation therapy." ClinicoEconomics and outcomes research : CEOR vol. 5 (2013): 545-53. doi: https://doi.org/10.2147/CEOR.S51446
Foroutan N, Rasekh HR, Salamzadeh J, Jamshidi HR, Nafar M. Budget impact analysis of conversion from cyclosporine to sirolimus as immunosuppressive medication in renal transplantation therapy. Clinicoecon Outcomes Res. 2013 Oct 18;5:545-53. doi: 10.2147/CEOR.S51446. eCollection 2013. PMID: 24159260; PMCID: PMC3806112.
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Clinicoecon Outcomes Res. 2013 Oct 18;5:545-53. doi: 10.2147/CEOR.S51446. eCollection 2013.

Budget impact analysis of conversion from cyclosporine to sirolimus as immunosuppressive medication in renal transplantation therapy.

ClinicoEconomics and outcomes research : CEOR

Naghmeh Foroutan, Hamid R Rasekh, Jamshid Salamzadeh, Hamid R Jamshidi, Mohsen Nafar

Affiliations

  1. Department of Pharmacoeconomics and Pharmaceutical Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

PMID: 24159260 PMCID: PMC3806112 DOI: 10.2147/CEOR.S51446

Abstract

OBJECTIVES: The aim of this study was to determine budget impact of conversion from cyclosporine (CsA) to sirolimus (SRL) in renal transplant therapy (RTT) from the perspective of insurance organizations in Iran.

METHODS: An Excel-based model was developed to determine cost of RTT, comparing current CsA based therapy to an mTOR inhibitor-based therapy regimen. Total cost included both cost of immunosuppressive agents and relative adverse events. The inputs were derived from database of Ministry of Health and insurance organizations, hospital and pharmacy based registries, and available literature that were varied through a one-way sensitivity analysis. According to the model, there were almost 17,000 patients receiving RTT in Iran, out of which about 2,200 patients underwent the operation within the study year. The model was constructed based on the results of a local RCT, in which test and control groups received CsA, SRL, and steroids over the first 3 months posttransplantation and, from the fourth month on, CsA, mycophenolate mofetil (MMF), and steroids were used in the CsA group and SRL, MMF, and steroids were administered in the SRL group, respectively.

RESULTS: The estimated cost of RTT with CsA was US$4,850,000 versus US$4,300,000 receiving SRL. These costs corresponded to the cost saving of almost US$550,000 for the payers.

CONCLUSION: To evaluate the financial consequence of adding mTOR inhibitors to the insurers' formulary, in the present study, a budget impact analysis was conducted on sirolimus. Fewer cases of costly adverse events along with lower required doses of MMF related to SRL based therapies were major reasons for this saving budgetary impact.

Keywords: budget impact; health insurance; mTOR inhibitors; out-of-pocket; renal transplantation

References

  1. Transplantation. 2001 Jan 27;71(2):271-80 - PubMed
  2. Transplant Proc. 1997 Feb-Mar;29(1-2):48-50 - PubMed
  3. Transplant Proc. 2008 Dec;40(10 Suppl):S25-8 - PubMed
  4. Clin Ther. 2005 Nov;27(11):1834-46 - PubMed
  5. Transplantation. 1999 Apr 15;67(7):1036-42 - PubMed
  6. Iran J Kidney Dis. 2012 Jul;6(4):300-6 - PubMed
  7. Value Health. 2007 Sep-Oct;10(5):336-47 - PubMed
  8. Am J Transplant. 2007 Nov;7(11):2522-31 - PubMed
  9. Nephrol Dial Transplant. 2007 Sep;22 Suppl 8:viii61-viii65 - PubMed
  10. Value Health. 2004 Jan-Feb;7(1):1-10 - PubMed
  11. Exp Clin Transplant. 2011 Feb;9(1):42-9 - PubMed
  12. Kidney Int. 2010 Dec;78(11):1068-74 - PubMed
  13. Int J Health Care Finance Econ. 2011 Dec;11(4):267-85 - PubMed
  14. Urol J. 2007 Spring;4(2):66-70 - PubMed
  15. Pharmacoeconomics. 2008;26(6):477-95 - PubMed
  16. J Nephropathol. 2012 Apr;1(1):5-10 - PubMed
  17. Eur J Health Econ. 2011 Jun;12(3):231-41 - PubMed
  18. Transplantation. 2006 May 15;81(9):1234-48 - PubMed

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