Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation: An economic evaluation

C. M. Legendre, Douglas Norman, M. R. Keating, G. D H Maclaine, D. M. Grant, Gillian Barnett

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Background. Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality in solid organ transplant patients and is associated with large additional healthcare expenditures. An economic evaluation of valaciclovir CMV prophylaxis in a renal transplant population is reported. Methods. Medical resource use data were collected alongside a multicenter multinational randomized, placebo-controlled, double-blind trial of valaciclovir CMV prophylaxis in renal transplantation. Patients were stratified into donor seropositive/recipient seronegative (D+R-) and recipient seropositive (R+) groups. Patients were followed-up 6 months posttransplant. A cost-effectiveness analysis from the perspective of the French health care system was performed using the number of cases of CMV disease avoided at 6 months as the clinical endpoint. Results. Resource use was significantly increased among patients who developed CMV disease compared to those who did not develop disease. In the high risk D+R- group, valaciclovir prophylaxis was associated with an average of 5.5 fewer inpatient hospital days (P≤0.05) and with significantly lower use of other healthcare resources. In the R+ group, valaciclovir prophylaxis prevented cases of CMV disease at a marginally greater mean cost per patient compared with placebo. For D+R- patients valaciclovir prophylaxis was therefore an economically superior strategy, resulting in fewer cases of CMV disease and lower total mean healthcare expenditures. Conclusions. Valaciclovir CMV prophylaxis in renal transplantation is a more cost-effective therapy compared with placebo, in the high-risk D+R- patient population. For the R+ group, the incremental cost per case of CMV disease was modest.

Original languageEnglish (US)
Pages (from-to)1463-1468
Number of pages6
JournalTransplantation
Volume70
Issue number10
StatePublished - Nov 27 2000

Fingerprint

valacyclovir
Cytomegalovirus Infections
Cytomegalovirus
Kidney Transplantation
Cost-Benefit Analysis
Delivery of Health Care
Placebos
Health Expenditures
Costs and Cost Analysis
Transplants

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Legendre, C. M., Norman, D., Keating, M. R., Maclaine, G. D. H., Grant, D. M., & Barnett, G. (2000). Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation: An economic evaluation. Transplantation, 70(10), 1463-1468.

Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation : An economic evaluation. / Legendre, C. M.; Norman, Douglas; Keating, M. R.; Maclaine, G. D H; Grant, D. M.; Barnett, Gillian.

In: Transplantation, Vol. 70, No. 10, 27.11.2000, p. 1463-1468.

Research output: Contribution to journalArticle

Legendre, CM, Norman, D, Keating, MR, Maclaine, GDH, Grant, DM & Barnett, G 2000, 'Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation: An economic evaluation', Transplantation, vol. 70, no. 10, pp. 1463-1468.
Legendre CM, Norman D, Keating MR, Maclaine GDH, Grant DM, Barnett G. Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation: An economic evaluation. Transplantation. 2000 Nov 27;70(10):1463-1468.
Legendre, C. M. ; Norman, Douglas ; Keating, M. R. ; Maclaine, G. D H ; Grant, D. M. ; Barnett, Gillian. / Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation : An economic evaluation. In: Transplantation. 2000 ; Vol. 70, No. 10. pp. 1463-1468.
@article{4101fcfeef584501b36d10e083f5da9c,
title = "Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation: An economic evaluation",
abstract = "Background. Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality in solid organ transplant patients and is associated with large additional healthcare expenditures. An economic evaluation of valaciclovir CMV prophylaxis in a renal transplant population is reported. Methods. Medical resource use data were collected alongside a multicenter multinational randomized, placebo-controlled, double-blind trial of valaciclovir CMV prophylaxis in renal transplantation. Patients were stratified into donor seropositive/recipient seronegative (D+R-) and recipient seropositive (R+) groups. Patients were followed-up 6 months posttransplant. A cost-effectiveness analysis from the perspective of the French health care system was performed using the number of cases of CMV disease avoided at 6 months as the clinical endpoint. Results. Resource use was significantly increased among patients who developed CMV disease compared to those who did not develop disease. In the high risk D+R- group, valaciclovir prophylaxis was associated with an average of 5.5 fewer inpatient hospital days (P≤0.05) and with significantly lower use of other healthcare resources. In the R+ group, valaciclovir prophylaxis prevented cases of CMV disease at a marginally greater mean cost per patient compared with placebo. For D+R- patients valaciclovir prophylaxis was therefore an economically superior strategy, resulting in fewer cases of CMV disease and lower total mean healthcare expenditures. Conclusions. Valaciclovir CMV prophylaxis in renal transplantation is a more cost-effective therapy compared with placebo, in the high-risk D+R- patient population. For the R+ group, the incremental cost per case of CMV disease was modest.",
author = "Legendre, {C. M.} and Douglas Norman and Keating, {M. R.} and Maclaine, {G. D H} and Grant, {D. M.} and Gillian Barnett",
year = "2000",
month = "11",
day = "27",
language = "English (US)",
volume = "70",
pages = "1463--1468",
journal = "Transplantation",
issn = "0041-1337",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Valaciclovir prophylaxis of cytomegalovirus infection and disease in renal transplantation

T2 - An economic evaluation

AU - Legendre, C. M.

AU - Norman, Douglas

AU - Keating, M. R.

AU - Maclaine, G. D H

AU - Grant, D. M.

AU - Barnett, Gillian

PY - 2000/11/27

Y1 - 2000/11/27

N2 - Background. Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality in solid organ transplant patients and is associated with large additional healthcare expenditures. An economic evaluation of valaciclovir CMV prophylaxis in a renal transplant population is reported. Methods. Medical resource use data were collected alongside a multicenter multinational randomized, placebo-controlled, double-blind trial of valaciclovir CMV prophylaxis in renal transplantation. Patients were stratified into donor seropositive/recipient seronegative (D+R-) and recipient seropositive (R+) groups. Patients were followed-up 6 months posttransplant. A cost-effectiveness analysis from the perspective of the French health care system was performed using the number of cases of CMV disease avoided at 6 months as the clinical endpoint. Results. Resource use was significantly increased among patients who developed CMV disease compared to those who did not develop disease. In the high risk D+R- group, valaciclovir prophylaxis was associated with an average of 5.5 fewer inpatient hospital days (P≤0.05) and with significantly lower use of other healthcare resources. In the R+ group, valaciclovir prophylaxis prevented cases of CMV disease at a marginally greater mean cost per patient compared with placebo. For D+R- patients valaciclovir prophylaxis was therefore an economically superior strategy, resulting in fewer cases of CMV disease and lower total mean healthcare expenditures. Conclusions. Valaciclovir CMV prophylaxis in renal transplantation is a more cost-effective therapy compared with placebo, in the high-risk D+R- patient population. For the R+ group, the incremental cost per case of CMV disease was modest.

AB - Background. Cytomegalovirus (CMV) disease is a major cause of morbidity and mortality in solid organ transplant patients and is associated with large additional healthcare expenditures. An economic evaluation of valaciclovir CMV prophylaxis in a renal transplant population is reported. Methods. Medical resource use data were collected alongside a multicenter multinational randomized, placebo-controlled, double-blind trial of valaciclovir CMV prophylaxis in renal transplantation. Patients were stratified into donor seropositive/recipient seronegative (D+R-) and recipient seropositive (R+) groups. Patients were followed-up 6 months posttransplant. A cost-effectiveness analysis from the perspective of the French health care system was performed using the number of cases of CMV disease avoided at 6 months as the clinical endpoint. Results. Resource use was significantly increased among patients who developed CMV disease compared to those who did not develop disease. In the high risk D+R- group, valaciclovir prophylaxis was associated with an average of 5.5 fewer inpatient hospital days (P≤0.05) and with significantly lower use of other healthcare resources. In the R+ group, valaciclovir prophylaxis prevented cases of CMV disease at a marginally greater mean cost per patient compared with placebo. For D+R- patients valaciclovir prophylaxis was therefore an economically superior strategy, resulting in fewer cases of CMV disease and lower total mean healthcare expenditures. Conclusions. Valaciclovir CMV prophylaxis in renal transplantation is a more cost-effective therapy compared with placebo, in the high-risk D+R- patient population. For the R+ group, the incremental cost per case of CMV disease was modest.

UR - http://www.scopus.com/inward/record.url?scp=0034722676&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034722676&partnerID=8YFLogxK

M3 - Article

C2 - 11118091

AN - SCOPUS:0034722676

VL - 70

SP - 1463

EP - 1468

JO - Transplantation

JF - Transplantation

SN - 0041-1337

IS - 10

ER -