Economics of the antithymocyte globulins Thymoglobulin® and Atgam® in the treatment of acute renal transplant rejection

Mark A. Schnitzler, Robert S. Woodward, Jeffrey A. Lowell, Leah Amir, Timothy J. Schroeder, Gary G. Singer, Daniel Brennan

Research output: Contribution to journalArticle

Abstract

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®.

Original languageEnglish (US)
Pages (from-to)287-293
Number of pages7
JournalPharmacoEconomics
Volume17
Issue number3
DOIs
StatePublished - Jan 1 2000
Externally publishedYes

Fingerprint

Antilymphocyte Serum
Graft Rejection
Economics
Kidney
Confidence Intervals
Medicare
Costs and Cost Analysis
Therapeutics
Arm
Clinical Trials
Transplants
Cost Savings
thymoglobulin
Multicenter Studies
Dialysis
Adrenal Cortex Hormones
Safety

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Economics of the antithymocyte globulins Thymoglobulin® and Atgam® in the treatment of acute renal transplant rejection. / Schnitzler, Mark A.; Woodward, Robert S.; Lowell, Jeffrey A.; Amir, Leah; Schroeder, Timothy J.; Singer, Gary G.; Brennan, Daniel.

In: PharmacoEconomics, Vol. 17, No. 3, 01.01.2000, p. 287-293.

Research output: Contribution to journalArticle

Schnitzler, Mark A. ; Woodward, Robert S. ; Lowell, Jeffrey A. ; Amir, Leah ; Schroeder, Timothy J. ; Singer, Gary G. ; Brennan, Daniel. / Economics of the antithymocyte globulins Thymoglobulin® and Atgam® in the treatment of acute renal transplant rejection. In: PharmacoEconomics. 2000 ; Vol. 17, No. 3. pp. 287-293.
@article{7d409d2b09594a789c43c52180fb5e3f,
title = "Economics of the antithymocyte globulins Thymoglobulin{\circledR} and Atgam{\circledR} in the treatment of acute renal transplant rejection",
abstract = "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{\circledR} or Atgam{\circledR}. Design and setting: This was a cost analysis of a randomised double-blind multicentre clinical trial comparing the safety and efficacy of Thymoglobulin{\circledR} and Atgam{\circledR} 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{\circledR} arm and 81 in the Atgam{\circledR} 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{\circledR} (1.5 mg/kg/day) for an average of 10 days or intravenous Atgam{\circledR} (15 mg/kg/day) for an average of 9.7 days. Results: On average, Thymoglobulin{\circledR} provided significant cost savings compared with Atgam{\circledR} 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{\circledR} 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{\circledR} is a cost saving strategy when compared with treatment with Atgam{\circledR}.",
author = "Schnitzler, {Mark A.} and Woodward, {Robert S.} and Lowell, {Jeffrey A.} and Leah Amir and Schroeder, {Timothy J.} and Singer, {Gary G.} and Daniel Brennan",
year = "2000",
month = "1",
day = "1",
doi = "10.2165/00019053-200017030-00006",
language = "English (US)",
volume = "17",
pages = "287--293",
journal = "PharmacoEconomics",
issn = "1170-7690",
publisher = "Adis International Ltd",
number = "3",

}

TY - JOUR

T1 - Economics of the antithymocyte globulins Thymoglobulin® and Atgam® in the treatment of acute renal transplant rejection

AU - Schnitzler, Mark A.

AU - Woodward, Robert S.

AU - Lowell, Jeffrey A.

AU - Amir, Leah

AU - Schroeder, Timothy J.

AU - Singer, Gary G.

AU - Brennan, Daniel

PY - 2000/1/1

Y1 - 2000/1/1

N2 - 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®.

AB - 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®.

UR - http://www.scopus.com/inward/record.url?scp=0034001163&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034001163&partnerID=8YFLogxK

U2 - 10.2165/00019053-200017030-00006

DO - 10.2165/00019053-200017030-00006

M3 - Article

VL - 17

SP - 287

EP - 293

JO - PharmacoEconomics

JF - PharmacoEconomics

SN - 1170-7690

IS - 3

ER -