Graft failure in Kidney Transplant is associated with high direct costs and a decrease in patients quality of life due to the turn back to dialysis or retransplant. New interventions are needed to improve immunosuppressive drugs adjustment in an individualized way to prevent graft failure, reduce related adverse events and decrease the associated costs.
A pharmacoeconomic model has been developed to estimate the potential impact of the IMMUNOBIOGRAM® in clinical outcomes and cost savings in the follow-up of patients with RT. Cost savings are expected to emerge in patients with high immunological risk that show low-sensitivity patterns to the IMSs they are taking in the IMMUNOBIOGRAM®, and could benefit from a change in IMSs regimen to decrease the graft rejection risk. On the other hand, patients with low immunological risk and a high sensitivity pattern to IMSs can profit from dose adjustments that can decrease the risk of IMSs severe adverse reactions like opportunistic infections or malignancies.
The objective of this evaluation was to estimate the economic impact of Immunobiogram use for the Spanish National-Health-System (NHS). Immunobiogram can help physicians to select the most appropriate IS and doses based on the in vitro pharmacodynamic profile of immune response to IS of each patient that it offers.
A hypothetical cohort (1,000 patients 1 year after renal transplantation) was modeled using a probabilistic second-order Monte Carlo simulation for a time horizon of 5 years under Spanish NHS perspective. Only direct costs were considered.
The results of this evaluation showed that in patients with high risk of graft rejection, the use of the IMBG would entail a potential risk reduction, with a saving of costs per patient in 5 years of € 20,279 and a 100% saving probability. For stable, low risk patients, the use of the IMBG would entail an expected reduction in the adverse events rate with savings of € 3,328 per patient in 5 years, and a 99.5% saving probability.
In conclusion, the routinely use of the Immunobiogram in patients one year after their kidney transplant may have considerable savings for the Spanish NHS.
The pharmacoeconomic model for the IMMUNOBIOGRAM® communicated in the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Congress 2019.
This model is flexible in the sense that can be later easily adapted to different countries (as the model depends upon the different variables and outcomes of the renal transplant specific situation of each country and its associated costs)