Pharmacoeconomic analysis of everolimus immunosuppressive therapy for de novo kidney transplant recipients in Russia
Currently, patients after kidney transplantation can receive mycophenolate mofetil (MPM), mycophenolic acid (MPA), cyclosporine (CSA) and tacrolimus (TAC) through the Federal High-cost Nosologies Program (VZN) in Russia. Use of everolimus (EVL) in combination with a reduced dose of calcineurin inhibitors has some advantages over the current practice of immunosuppressive therapy that is financed through VZN. Aim: to conduct a comprehensive pharmacoeconomic research of using EVL for immunosuppressive therapy of adult de novo kidney transplantation recipients in comparison with the current immunosuppressive therapy practice that is covered by the VZN Program in the Russian Federation. Materials and methods. According to the latest clinical data, effectiveness of immunosuppressive therapy schemes based on EVL and MPA is comparable, which allows to use ‘cost minimization’ method for pharmacoeconomic research. We also performed budget impact analysis of the VZN Program expenditures for a period of 2020-2022. Results. The three-year medication costs of using EVL-based immunosuppressive scheme were 502,785 RUB, which was 508,493 RUB (50.3%) less than medication costs of using MPA-based schemes that are covered by the VZN Program in current practice. The inclusion of EVL to the VZN Program will reduce its costs by 90 million RUB during the first year (2020), by 181 million RUB - during the second year (2021), and by 262 million RUB during the third year (2022). In three years VZN Program costs could be reduced by 533 million RUB (48.6%). Conclusion. Use of EVL is a cost-saving approach for immunosuppressive therapy of adult de novo kidney transplant recipients, compared to MPA-based schemes, that are covered by the VZN Program in current practice in Russia.