The aim of the study was to perform cost-effectiveness analysis of immunosuppressive drugs in post-renal transplantation maintenance therapy. A hypothetical cohort of transplanted adults was followed for 20 years, using the Markov model. The 10 evaluated therapeutic regimens contained prednisone (P). Average cost of the medicines was obtained from CMED (Câmara de Regulação do Mercado de Medicamentos). Other patient care costs were included in each disease stage. Costs were expressed in Brazilian reais, effectiveness was measured as years of life gained, and the study adopted a public health system perspective. At the end of follow-up, the analysis with discount showed that all the regimens were dominated by cyclosporine (CSA)+azathioprine (AZA)+P. In the remaining analyses, tacrolimus+AZA+P was not dominated, but the incremental cost-effectiveness ratio between these two regimens was R$ 156,732.07/ years of life gained, a value that exceeds the threshold of three times the Brazilian per capita GDP. In the sensitivity analysis, no qualitative change was observed and the probability of CSA+AZA+P being the most cost-effective regimen was greater than 85%.
Immunosuppressive Agents; Kidney Transplantation; Cost-Effectiveness Evaluation; Health Technology Assessment
