Cost-effectiveness of everolimus plus reduced tacrolimus in de novo liver-recipients in the Italian setting |
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| Authors: | Florence Bianic Rosanne Campbell Paolo De Simone Alessandro Roccia Jill Gregson |
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| Affiliation: | 1. Mapi Group, Nanterre, France;2. Mapi Group, Uxbridge, UK;3. University of Pisa Medical School Hospital, Pisa, Italy;4. Novartis Farma, Origgio, Italy;5. Novartis AG Ringgold, Basel, Basel-Stadt, Switzerland |
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| Abstract: | Introduction: Long-term exposure to calcineurin inhibitor-based immunosuppressant (IS) therapy in liver transplant (LT) recipients is associated with renal complications. In the randomized trial H2304, everolimus?+?reduced-dose tacrolimus (EVR?+?rTAC) demonstrated equivalent efficacy and superior renal function compared to standard-dose tacrolimus.Methods: To evaluate the cost-effectiveness of EVR?+?rTAC vs TAC, in de novo LT patients, a Markov model simulating both liver and kidney function was developed and estimated the long-term outcomes of IS following LT. The analysis used the Italian healthcare payer perspective.Results: Patients treated with EVR?+?rTAC gained on average 1.92 years and 1.62 quality-adjusted life years (QALYs). The incremental cost-effectiveness ratios (ICER) were €35,851 and €42,567 for LY gained and QALY gained, respectively. For the hepatitis-c sub-population, the ICERs decreased to €22,519 and €30,658, respectively.Conclusion: EVR?+?rTAC improves survival and quality-of-life and is a cost-effective alternative to calcineurin-inhibitor monotherapy for patients requiring LT. |
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| Keywords: | Cost-effectiveness Post-liver transplantation Everolimus Immunosuppressant therapies |
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