Abstract
Switching drug manufacturers in transplant patients may require an increased intensity of therapeutic monitoring, leading to additional healthcare visits, associated laboratory tests, and perhaps hospitalizations. As real-world studies examining the interchangeability of tacrolimus from different manufacturers are limited, the purpose of this study was to examine the healthcare resource utilization (HRU) and economic impact of tacrolimus-switching in kidney transplantation. This cross-sectional, retrospective study examined HRU and healthcare costs (HCCs) among patients with a kidney transplant who were prescribed tacrolimus from fixed-source (FS) vs variable-source (VS) manufacturers using claims data from the large US health plan Humana from October 1, 2012, to December 31, 2013. Overall, 1,024 patients were identified (FS: n = 674, 66%; VS: n = 350, 34%). The number of therapeutic drug monitoring (TDM) events for the VS group was 13% greater than for the FS group after controlling for demographics, comorbidity score, and number of medications (incidence rate ratio = 1.13, p = .033). Adjusted total HCCs were 9% lower for VS (US$28,054 vs US$30,823, p = .045). In the unadjusted analysis, VS had greater emergency department (ED...Continue Reading
References
Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Jan 9, 2001·Journal of Clinical Epidemiology·C N KlabundeJ L Warren
May 3, 2005·Journal of Clinical Epidemiology·Sebastian Schneeweiss, Jerry Avorn
Apr 14, 2006·Basic & Clinical Pharmacology & Toxicology·Sean Hennessy
Jul 12, 2008·Epilepsia·Woodie M ZachryBrien J Smith
Sep 25, 2009·The Annals of Pharmacotherapy·Barbara M DavitJanet Woodcock
Oct 23, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Mar 25, 2010·Drugs·Aaron S KesselheimWilliam H Shrank
Oct 23, 2010·Obstetrics and Gynecology·David A Grimes
Apr 1, 2011·Pharmacotherapy·Francesco DentaliUNKNOWN Warfarin Associated Research Projects and Other Endeavors (WARPED) Consortium
Jun 23, 2011·Epilepsia·Sara C EricksonBradford Curtis
Jul 1, 2011·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·J D MomperR Venkataramanan
Jul 5, 2012·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·R R AllowayR D Bloom
Nov 15, 2012·The Annals of Pharmacotherapy·Winghan Jacqueline KwongChristy Fang
Feb 1, 2013·Journal of Transplantation·K ParkerA M Wiland
Jun 19, 2013·Medical Care·William R HershJoel H Saltz
Oct 15, 2013·Clinical Transplantation·R D BloomR R Alloway
Jun 20, 2014·Clinical Kidney Journal·Staffan RosenborgPeter Bárány
Aug 26, 2014·Transplantation·Ida RobertsenKarsten Midtvedt
Jul 25, 2015·Surgery·Adam HauchJoseph F Buell