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Titolo:
A model for analyzing the cost of the main clinical events after lung transplantation
Autore:
Sharples, LD; Taylor, GJ; Karnon, J; Caine, N; Buxton, M; McNeil, K; Wallwork, J;
Indirizzi:
MRC, Biostat Unit, Cambridge CB2 2SR, England MRC Cambridge England CB2 2SR , Biostat Unit, Cambridge CB2 2SR, England Papworth Hosp, Res & Dev Unit, NHS Trust, Cambridge CB3 8RE, England Papworth Hosp Cambridge England CB3 8RE rust, Cambridge CB3 8RE, England Univ Bath, Postgrad Med Sch, Bath BA2 7AY, Avon, England Univ Bath Bath Avon England BA2 7AY Med Sch, Bath BA2 7AY, Avon, England Brunel Univ, Hlth Econ Res Grp, Uxbridge UB8 3PH, Middx, England Brunel Univ Uxbridge Middx England UB8 3PH bridge UB8 3PH, Middx, England
Titolo Testata:
JOURNAL OF HEART AND LUNG TRANSPLANTATION
fascicolo: 4, volume: 20, anno: 2001,
pagine: 474 - 482
SICI:
1053-2498(200104)20:4<474:AMFATC>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
LIVER-TRANSPLANTATION; RENAL-TRANSPLANTATION; ECONOMIC-ANALYSIS; IMMUNOSUPPRESSIVE REGIMENS; KIDNEY-TRANSPLANTATION; CYCLOSPORINE-A; PREVENTION; UTILITY; PROGRAM; FK-506;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Sharples, LD MRC, Biostat Unit, Univ Forvie Site,Robinson Way, Cambridge CB2 2SR, England MRC Univ Forvie Site,Robinson Way Cambridge England CB2 2SR
Citazione:
L.D. Sharples et al., "A model for analyzing the cost of the main clinical events after lung transplantation", J HEART LUN, 20(4), 2001, pp. 474-482

Abstract

Background: The aim of this project was to model clinically important events experienced by lung transplant patients (from the day after transplant to 5 years or death) and costs associated with these events, and to assess the economic impact of different immunosuppression therapies. Methods: The population comprised 356 lung transplant patients (223 heart-lung, 102 single lung and 31 double lung) transplanted between April 1984 and December 1997. AU patients received a cyclosporine-based triple-immunosuppression protocol. We designed a Markov model that included 3 time periods(0 to 6, 7 to 12, and 13 to 60 months), 5 clinical states (well, acute rejection, cytomegalovirus infection, non-cytomegalavirus infection and bronchiolitis obliterans syndrome), and death. For the well state, cost elements were immunosuppression, prophylaxis, and routine clinic visits. For all other states, cost elements were diagnosis, treatment, and bed days/visits. Weexcluded costs of the procedure. Results: The monthly costs associated with the well state decreased over time, from pound1,778 ($2,658) in the first 6 months to pound 503 ($752) in months 7 to 12 and pound 350 ($523) after the first 12 months. The cost perevent of the acute states remained reasonably constant over the 3 periods:pound1,850 ($2,766) for rejection, pound3,380 ($5,053) for cytomegalovirus, and pound2,790 ($4,171) for other infections. The average cost per patient, discounted at 6%, over 5 years was pound 35,429 ($52,966) (95% range, pound1,435 [$2,145] to pound 67,079 [$100,283]). This estimate is most sensitive to changes in immunosuppression. Substituting tacrolimus for cyclosporine increased 5-year costs by 5%; substituting mycophenolate mofetil for azathioprine increased 5-year costs by 26%. Conclusions: This model is valuable in estimating the effect of new immunosuppression agents on the costs of follow-up care.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 16:10:15