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Spotlight on Mycophenolate Mofetil in Solid Organ Transplantation

  • Adis Spotlight
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Disease Management & Health Outcomes

Abstract

Most pharmacoeconomic studies of mycophenolate mofetil have focused on its use as part of maintenance immunosuppression for renal transplantation, involving short-term (3–12 months) time frames. In general, mycophenolate mofetil reduced the treatment costs for rejection episodes and graft failure which offset its higher drug acquisition cost compared with azathioprine.

Several cost analyses have been modeled on the large multicenter trials of adult renal transplant recipients. The use of mycophenolate mofetil was associated with either cost savings or no additional costs after 6 or 12 months in French, US and Canadian analyses of triple or quadruple immunosuppressant therapy. A further cost analysis utilizing a registry database of renal transplant recipients in the US found mycophenolate mofetil to be cost saving compared with azathioprine after 6.4 years when evaluating costs due to graft loss only.

Of the limited cost-effectiveness analyses with the drug, one US study modeled the 1- and 10-year cost effectiveness of mycophenolate mofetil and various other immunosuppressants used in combined regimens. Long-term use of mycophenolate mofetil was less cost effective than other regimens, but the use of long-term mycophenolate mofetil in high-risk patients was shown to be a relatively cost-effective strategy. In another US analysis comparing mycophenolate mofetil with azathioprine as part of quadruple therapy, mycophenolate mofetil was associated with slightly lower costs during the first year after renal transplantation as well as improved clinical outcomes.

In conclusion, pharmacoeconomic studies support the use of mycophenolate mofetil as part of immunosuppressant therapy in renal transplantation, at least in the short term. Although the cost effectiveness of mycophenolate mofetil in the long term is less clear, limited pharmacoeconomic data available appear promising. Among issues to be examined in future economic analyses in renal transplantation are the calcineurin-sparing potential of mycophenolate mofetil and the feasibility of using more efficient mycophenolate mofetil dosage regimens when using the drug on a long-term basis. Additional pharmacoeconomic analyses of mycophenolate mofetil are also needed in other types of solid organ transplantation.

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Acknowledgements

The full text article in PharmacoEconomics 2002; 20 (10): 675–713 was reviewed by: M. Behrend, Abteilung Thoraxchirurgie, Universitatsklinikum Freiburg, Freiburg, Germany; D. E. Eckhoff, Department of Surgery, Division of Transplantation, University of Alabama at Birmingham, Birmingham, Alabama, USA; P. F. Halloran, Division of Nephrology and Immunology, University of Alberta Hospitals, Edmonton, Alberta, Canada; P. J. H. Smak Gregoor, Department of Internal Medicine, University Hospital Rotterdam, Rotterdam, Netherlands; S. D. Sullivan, Pharmaceutical Outcomes Research and Policy Program, Department of Pharmacy, University of Washington, Seattle, Washington, USA; R.P. Wuthrich, Division of Nephrology, University Hospital Rorschacherstrasse 95, Zurich, Switzerland.

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    Melissa Young & Greg L. Plosker

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Correspondence to Greg L. Plosker.

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This Spotlight is derived from abstract and summary text of an Adis Pharmacoeconomic Drug Evaluation originally published in full in PharmacoEconomics 2002; 20 (10): 675–713

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Young, M., Plosker, G.L. Spotlight on Mycophenolate Mofetil in Solid Organ Transplantation. Dis-Manage-Health-Outcomes 10, 805–809 (2002). https://doi.org/10.2165/00115677-200210120-00006

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