OBJECTIVES

Tacrolimus is an immunosuppression drug widely used for prevention of allograft rejection in kidney and liver transplantations. The once-daily extended-release tacrolimus (LCP-Tac) is a novel formulation for tacrolimus, differentiated by using the MeltDose technology which was designed to enhance the bioavailability of drugs with low water solubility. This study assessed the economic impact of the use LCP-Tac compared with other once-daily extended-release tacrolimus (PR-Tac) and with twice-daily immediate-release tacrolimus (IR-Tac) in patients with kidney or liver transplantation.

METHODS

An economic impact analysis was developed with a one-year time horizon, from the perspective of the Spanish National Health System (SNHS). A total of new kidney and liver transplants were identified. Two scenarios were compared, an actual scenario, assuming a market share of 12,34%, 60,32% and 27,34% for LCP-Tac, PR-Tac and IR-Tac respectively, and an alternative scenario in which 100% of these new transplanted patients would be treated with LCP-Tac. A 36% and 30% daily drug dose reduction (DDD) when switching from PR-Tac or IR-Tac to LCP-Tac respectively and the public list prices was considered to estimate the pharmacological costs. A sensitivity analysis (SA) was carried out with the retail price drug plus value added tax.

RESULTS

The results show that full treatment (100%) in these kidney or liver new transplanted patients with LCP-Tac would result in -€1,418,130.47 cost savings for the SNHS (a reduction of 30,8%). In the actual scenario, the annual cost was €4,611,676.07 and in the alternative scenario €3,193,545.60. LCP-Tac has a lower treatment cost per day than both, PR-Tac and IR-Tac: €1.88 versus €2.90 and €2.69. The SA estimates even higher cost savings (-€2,212,391.23).

CONCLUSIONS

The LCP-Tac treatment in kidney or liver new transplanted patients would represent considerable cost savings for the SNHS due to LCP-Tac better bioavailability that leads to a decrease in its DDD.