OBJECTIVES: To assess clinical effectiveness and costs of MMF or TAC use in immunosuppressive treatment from public payer's perspective in Poland. METHODS: Results of a SR of published clinical trials conducted in December 2006 according to Polish HTA Guidelines were used to assess effectiveness and safety for immunosuppressive therapy schemes: TAC+AZA+GCS or MMF+CsA+GCS. Weibull survival function was used to assess the risk of acute kidney rejection, graftectomy, dialysis, retransplantion (post-transplantation events) caused by used therapy. Costs of treatment valid from public payer's perspective were taken into account. Pharmacotherapy, drug administration and monitoring, patient monitoring, post-transplantation events influenced the total treatment cost. Markov model was used to assess costs of immunosuppressive therapies. Sensitivity analysis was conducted according to range of costs of MMF or TAC (+/-20%) available in Poland, MMF reimbursement categories and discount rates for effects and costs in line with the Polish HTA Guidelines (0% or 5%). All calculations were performed for 2007 (1EUR=3.8PLN). RESULTS: Indirect comparison of immunosuppressive therapy schemes were taken into account: TAC+AZA+GCS and MMF+CsA+GCS (CsA+AZA+GCS as common comparator). Review of RCTs for these therapies included in indirect comparison revealed no significant differences in their effectiveness and safety. TAC use was associated with significantly higher costs from public payer's perspective compared to MMF (difference: 97457PLN-135616PLN) per therapy in accordance with assumed reimbursement category for MMF (lump co-payment – 50% co-payment). Sensitivity analysis confirmed that MMF's scheme was cheaper compared to TAC's scheme from public payer's perspective in Poland. CONCLUSION: MMF's therapeutic scheme use in place of TAC's scheme lead to significant savings for public payer in kidney transplant immunosuppressive therapy in Poland.