OBJECTIVES: Maintenance immunosuppressive regimens in heart transplantation usually include a calcineurin inhibitor. Cyclosporine and tacrolimus are the calcineurin inhibitors used as primary immunosuppression in Colombia. However, tacrolimus is not currently cited in the National Benefit Plan, and data concerning the budget impact of tacrolimus is needed for the Colombian government to consider its inclusion. This research was undertaken to estimate the impact of the tacrolimus-mycophenolate mofetil (TAC-MMF) regimen on the Colombian third-party payer budget

METHODS: A budget impact model was designed to compare two scenarios over a 5-year time horizon: in the first, 21.8% of the market was constituted by TAC-MMF and the remaining percentage by the cyclosporine-mycophenolate mofetil (CYC-MMF) regimen throughout the time horizon; in the second, the TAC-MMF regimen progressively increased its market share until reaching 97%. Acquisition, monitoring and acute rejection costs were considered. These costs were estimated using the Social Security (Instituto del Seguro Social) Rates Manual and reports from Medicine Price Information System, and the resources and cost-generating events were identified using a base case constructed with clinical experts

RESULTS: Under the scenarios considered, the progressive adoption of the TAC-MMF regimen resulted in savings in the budget of the third-party payer of US $1234, $5147, $15,499, $37,114, and $79,393 at Years 1–5, respectively (US $1 = Colombian peso ~3763, November 2020). Savings were mainly related to costs of acquiring technologies and decreased rejection events related to TAC-MMF use versus the CYC-MMF regimen.

CONCLUSIONS: Based on the findings from this budget impact model, the TAC-MMF regimen represents savings for the Colombian third-party payer and the healthcare system compared with CYC-MMF.