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2015 ; 2015
(ä): 917567
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Cost-Utility Analysis of Mycophenolate Mofetil versus Azathioprine Based Regimens
for Maintenance Therapy of Proliferative Lupus Nephritis
#MMPMID26600951
Nee R
; Rivera I
; Little DJ
; Yuan CM
; Abbott KC
Int J Nephrol
2015[]; 2015
(ä): 917567
PMID26600951
show ga
Background/Aims. We aimed to examine the cost-effectiveness of mycophenolate
mofetil (MMF) and azathioprine (AZA) as maintenance therapy for patients with
Class III and Class IV lupus nephritis (LN), from a United States (US)
perspective. Methods. Using a Markov model, we conducted a cost-utility analysis
from a societal perspective over a lifetime horizon. The modeled population
comprised patients with proliferative LN who received maintenance therapy with
MMF (2?gm/day) versus AZA (150?mg/day) for 3 years. Risk estimates of clinical
events were based on a Cochrane meta-analysis while costs and utilities were
retrieved from other published sources. Outcome measures included costs,
quality-adjusted life-years (QALY), incremental cost-effectiveness ratios (ICER),
and net monetary benefit. Results. The base-case model showed that, compared with
AZA strategy, the ICER for MMF was $2,630,592/QALY at 3 years. Over the patients'
lifetime, however, the ICER of MMF compared to AZA was $6,454/QALY. Overall, the
ICER results from various sensitivity and subgroup analyses did not alter the
conclusions of the model simulation. Conclusions. In the short term, an AZA-based
regimen confers greater value than MMF for the maintenance therapy of
proliferative LN. From a lifelong perspective, however, MMF is cost-effective
compared to AZA.