OBJECTIVES: Induction immunosuppression therapy is used to support optimal outcomes in kidney transplantation. This study was to assess the cost-effectiveness of Thymoglobuline (Rabbit Anti-human Thymocyte Immunoglobulin) versus ATG-Fresenius (Anti-T lymphocyte globulin) in kidney transplantation in the Chinese setting. METHODS:  A two-part survival model was developed consisting of a “short-term” part and a “long-term” part. The “short-term” part analyzed the first-year using decision tree and consisted of the “functioning transplant”, “acute rejection (AR)”, “delayed graft function (DGF)”, “dialysis”, and “death” health states. The “long-term” part analyzed the two to five-year using Markov model and consisted of the “functioning transplant”, “chronic dysfunction”, “recurring primary disease”, “dialysis”, and “death” health states, with capture of the association between DGF and graft loss. Costs including drug acquisition and other direct medical costs were derived from GBI SOURCE CHINA database, chart review and expert panels. Clinical outcomes and utility were retrieved from published literature. The model calculated quality-adjusted life years (QALYs) and total costs per patient. Costs and QALYs were discounted at an annual rate of 3.5%. Sensitivity analyses will be conducted in this ongoing study. RESULTS: Patients receiving Thymoglobuline observed more clinical effectiveness than patients receiving ATG-Fresenius mainly due to less AR, DGF and dialysis. The incremental QALY was 0.0297 over a 1-year horizon and 0.0392 over a 5-year horizon. Thymoglobuline and ATG-Fresenius drug cost were ¥15,602 and ¥11,580, respectively. However, the total treatment costs of the Thymoglobuline arm were lower than the ATG-Fresenius arm due to lower costs related to DGF, AR, dialysis and adverse events. In total, Thymoglobuline saves ¥4,407 and ¥11,490 over the 1-year and 5-year horizon, respectively. Thymoglobuline was dominant compared with ATG-Fresenius. CONCLUSIONS: Despite higher drug acquisition costs, thymoglobuline-treated patients achieve better short and long term outcomes, resulting in cost savings by avoidance of graft failure and long-term dialysis costs.