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Article: Cost comparison between mycophenolate mofetil and cyclophosphamide- azathioprine in the treatment of lupus nephritis

TitleCost comparison between mycophenolate mofetil and cyclophosphamide- azathioprine in the treatment of lupus nephritis
Authors
Issue Date2009
PublisherJournal of Rheumatology Publishing Co Ltd. The Journal's web site is located at http://www.jrheum.com
Citation
Journal Of Rheumatology, 2009, v. 36 n. 1, p. 76-81 How to Cite?
AbstractObjective. To compare the healthcare expenditure associated with mycophenolate mofetil (MMF)-based immunosuppression in contrast to conventional therapy in patients with lupus nephritis. Methods. Our retrospective single-center study compared the major healthcare costs during the first 24 months of treatment incurred by immunosuppressive medications, hospitalization, and complications in patients with severe lupus nephritis who had been treated with prednisolone and either MMF or sequential cyclophosphamide induction followed by azathioprine maintenance (CTX-AZA). Results. Forty-four patients were studied (22 in each group). Baseline demographic and clinical measures, and remission rates after treatment, were similar between the 2 groups. Immunosuppressive drug cost was 13.6-fold higher in the MMF group (US$4168.3 ± 1176.5 per patient, compared with $285.0 ± 70.6 in the CTX-AZA group, mean difference $3883.2 ± 251.3; p < 0.001). MMF treatment was associated with a lower incidence of infections (12.0 episodes/1000 patient-months, compared with 32.4 in the CTX-AZA group; p = 0.035). Combined cost of hospitalization and treatment of infections was 82.5% lower in the MMF group (mean difference -2208.7 ± 1700.6; p = 0.120). Overall treatment expenditure on immunosuppressive drugs, hospitalization, and treatment of infections was 1.57-fold higher in the MMF group (mean US $4635.9 compared with $2961.5 in the CTX-AZA group; p < 0.001). Conclusion. While the cost of MMF treatment for severe lupus nephritis is much higher compared with CTX-AZA, the increased drug cost is partially offset by savings from the reduced incidence of complications. The Journal of Rheumatology Copyright © 2009. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/163223
ISSN
2015 Impact Factor: 3.236
2015 SCImago Journal Rankings: 1.225
ISI Accession Number ID
Funding AgencyGrant Number
Wai Hung Charitable Foundation
Funding Information:

Supported by research funding from the Wai Hung Charitable Foundation.

References

 

DC FieldValueLanguage
dc.contributor.authorTse, KCen_US
dc.contributor.authorTang, CSOen_US
dc.contributor.authorLam, MFen_US
dc.contributor.authorYap, DYHen_US
dc.contributor.authorChan, TMen_US
dc.date.accessioned2012-09-05T05:28:54Z-
dc.date.available2012-09-05T05:28:54Z-
dc.date.issued2009en_US
dc.identifier.citationJournal Of Rheumatology, 2009, v. 36 n. 1, p. 76-81en_US
dc.identifier.issn0315-162Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/163223-
dc.description.abstractObjective. To compare the healthcare expenditure associated with mycophenolate mofetil (MMF)-based immunosuppression in contrast to conventional therapy in patients with lupus nephritis. Methods. Our retrospective single-center study compared the major healthcare costs during the first 24 months of treatment incurred by immunosuppressive medications, hospitalization, and complications in patients with severe lupus nephritis who had been treated with prednisolone and either MMF or sequential cyclophosphamide induction followed by azathioprine maintenance (CTX-AZA). Results. Forty-four patients were studied (22 in each group). Baseline demographic and clinical measures, and remission rates after treatment, were similar between the 2 groups. Immunosuppressive drug cost was 13.6-fold higher in the MMF group (US$4168.3 ± 1176.5 per patient, compared with $285.0 ± 70.6 in the CTX-AZA group, mean difference $3883.2 ± 251.3; p < 0.001). MMF treatment was associated with a lower incidence of infections (12.0 episodes/1000 patient-months, compared with 32.4 in the CTX-AZA group; p = 0.035). Combined cost of hospitalization and treatment of infections was 82.5% lower in the MMF group (mean difference -2208.7 ± 1700.6; p = 0.120). Overall treatment expenditure on immunosuppressive drugs, hospitalization, and treatment of infections was 1.57-fold higher in the MMF group (mean US $4635.9 compared with $2961.5 in the CTX-AZA group; p < 0.001). Conclusion. While the cost of MMF treatment for severe lupus nephritis is much higher compared with CTX-AZA, the increased drug cost is partially offset by savings from the reduced incidence of complications. The Journal of Rheumatology Copyright © 2009. All rights reserved.en_US
dc.languageengen_US
dc.publisherJournal of Rheumatology Publishing Co Ltd. The Journal's web site is located at http://www.jrheum.comen_US
dc.relation.ispartofJournal of Rheumatologyen_US
dc.subject.meshAdulten_US
dc.subject.meshAzathioprine - Administration & Dosage - Adverse Effects - Economicsen_US
dc.subject.meshCyclophosphamide - Administration & Dosage - Adverse Effects - Economicsen_US
dc.subject.meshDrug Costs - Statistics & Numerical Dataen_US
dc.subject.meshFemaleen_US
dc.subject.meshHospital Costs - Statistics & Numerical Dataen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunocompromised Hosten_US
dc.subject.meshImmunosuppressive Agents - Administration & Dosage - Adverse Effects - Economicsen_US
dc.subject.meshIncidenceen_US
dc.subject.meshInfection - Economics - Epidemiology - Etiologyen_US
dc.subject.meshLupus Nephritis - Drug Therapy - Economics - Epidemiologyen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMycophenolic Acid - Administration & Dosage - Adverse Effects - Analogs & Derivatives - Economicsen_US
dc.subject.meshPneumonia - Economics - Epidemiology - Etiologyen_US
dc.subject.meshYoung Adulten_US
dc.titleCost comparison between mycophenolate mofetil and cyclophosphamide- azathioprine in the treatment of lupus nephritisen_US
dc.typeArticleen_US
dc.identifier.emailYap, DYH:desmondy@hku.hken_US
dc.identifier.emailChan, TM:dtmchan@hku.hken_US
dc.identifier.authorityYap, DYH=rp01607en_US
dc.identifier.authorityChan, TM=rp00394en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.3899/jrheum.080517en_US
dc.identifier.pmid19004041-
dc.identifier.scopuseid_2-s2.0-58149517586en_US
dc.identifier.hkuros162911-
dc.identifier.hkuros210065-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-58149517586&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume36en_US
dc.identifier.issue1en_US
dc.identifier.spage76en_US
dc.identifier.epage81en_US
dc.identifier.isiWOS:000262535300014-
dc.publisher.placeCanadaen_US
dc.identifier.scopusauthoridTse, KC=7102609864en_US
dc.identifier.scopusauthoridTang, CSO=8681865300en_US
dc.identifier.scopusauthoridLam, MF=35300050600en_US
dc.identifier.scopusauthoridYap, DYH=25958532000en_US
dc.identifier.scopusauthoridChan, TM=7402687700en_US

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