Use of Markov modeling for evaluating the cost-effectiveness of immunosuppressive therapies in renal transplant recipients
Lewis, R.L.; Canafax, D.M.; Pettit, K.G.; DiCesare, J.; Kaniecki, D.J.; Arnold, R.J.; Roberts, M.S.
Transplantation Proceedings 28(4): 2214-2217
1996
ISSN/ISBN: 0041-1345 PMID: 8769203 Document Number: 3600
The present analysis could have been strengthened had all clinical data in the HCFA database been derived from clinical sources rather than billing information. For example, the HCFA database was unable to distinguish between antibody-treated and corticosteroid-treated rejections. This could have impacted significantly on cost-effectiveness ratios in view of the fact that less monoclonal antibody use was documented in the Neoral arms of both the US and European trials in comparison to the Sandimmune-treated, concurrent controls. Constraints of the HCFA database required calculation of a mean cost for all rejection episodes without regard to the treatment used. Clearly, issues of cost standardization, and discrepancies between costs vs charges, characterize the present study as they do most current pharmacoeconomic analyses.
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