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Economics of the Antithymocyte Globulins Thymoglobulin® and Atgam® in the Treatment of Acute Renal Transplant Rejection

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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 rejectionwith Thymoglobulin® is a cost saving strategy when compared with treatment with Atgam®.

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Acknowledgements

This study was supported in part by a grant from the SangStat Medical Corporation, Menlo Park, California, USA.

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Authors and Affiliations

  1. Pharmaco-Economic Transplant Research, Washington University, St Louis, Missouri, USA

    Mark A. Schnitzler, Robert S. Woodward, Jeffrey A. Lowell & Daniel C. Brennan

  2. The Health Administration Program, Washington University School of Medicine, 4547 Clayton Avenue, St Louis, Missouri, 63110, USA

    Mark A. Schnitzler & Robert S. Woodward

  3. Department of Surgery, Washington University, St Louis, Missouri, USA

    Jeffrey A. Lowell

  4. Quality Resource Management Inc., St Louis, Missouri, USA

    Leah Amir

  5. Department of Pathology and Laboratory Medicine, University of Cincinnati Medical Center, Cincinnati, Ohio, USA

    Timothy J. Schroeder

  6. Department of Internal Medicine, Washington University, St Louis, Missouri, USA

    Gary G. Singer & Daniel C. Brennan

Authors
  1. Mark A. Schnitzler
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  2. Robert S. Woodward
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  3. Jeffrey A. Lowell
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  4. Leah Amir
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  5. Timothy J. Schroeder
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  6. Gary G. Singer
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  7. Daniel C. Brennan
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Corresponding author

Correspondence to Mark A. Schnitzler.

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Schnitzler, M.A., Woodward, R.S., Lowell, J.A. et al. Economics of the Antithymocyte Globulins Thymoglobulin® and Atgam® in the Treatment of Acute Renal Transplant Rejection. Pharmacoeconomics 17, 287–293 (2000). https://doi.org/10.2165/00019053-200017030-00006

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  • DOI: https://doi.org/10.2165/00019053-200017030-00006

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