PUK20 Cost-Utility Assessment of Sirolimus Versus Tacrolimus for Primary Prevention of Graft Rejection in Renal Transplant Recipients in Mexico (original) (raw)

with pharmacist-managed ESA clinics (nϭ314) and at six sites with usual care only (nϭ167); outpatients were followed for 6 months in 2009. We took a VA perspective with projections over a five-year time horizon; costs and effectiveness values were discounted at 3%/yr. Strategy-specific likelihoods of target range hemoglobin values (10-12 g/dl) were based on study results. Utilities for ND-CKD and ESA-related adverse events and their likelihood were obtained from the literature. ESA costs were based on average monthly epoetin and darbepoetin doses per patient during the study and VA ESA cost data. RESULTS: In the base case analysis, cost and effectiveness were 12,500and2.096quality−adjustedlife−years(QALYs)inthepharmacistmanagedESAclinicsand12,500 and 2.096 quality-adjusted life-years (QALYs) in the pharmacistmanaged ESA clinics and 12,500and2.096quality−adjustedlife−years(QALYs)inthepharmacistmanagedESAclinicsand15,500 and 2.093 QALYs in usual care; ESA clinics dominated usual care. In one-way sensitivity analyses, ESA clinics no longer dominated if their patients' probability of being in the target range fell to 0.54 (base case 0.