COST MINIMIZATION ANALYSIS OF ORAL VALGANCICLOVIR VERSUS INTRAVENOUS AND ORAL GANCICLOVIR IN THE PREVENTION OF CYTOMEGALOVIRUS INFECTION AND DISEASE IN SOLID ORGAN TRANSPLANT RECIPIENTS

Abstract

P813 Aims: To assess the efficiency of long-term prophylaxis with oral valganciclovir versus sequential intravenous/oral ganciclovir in the prevention of cytomegalovirus (CMV) infection and disease in solid organ transplant recipients. Methods: A cost minimization analysis was performed from the perspective of the Spanish National Health System and differential direct medical costs between both treatments were considered. The efficacy data of valganciclovir regimen was obtained from Paya et al.’sA clinical trial. It was conducted a literature review of published clinical trials in order to obtain the efficacy data of high-risk transplant patients (D+R) treated with sequential intravenous/oral ganciclovir. Resource use, including medication, in the prophylactic treatment with intravenous/oral ganciclovir were retrieved from published literature and a retrospective review of 83 clinical charts of kidney, liver and lung transplant patients in 9 Spanish hospitals. The resources used with valganciclovir were retrieved from Paya et al.’sA clinical trial. The unit costs of resources were obtained from published literature and national databases (€ 2003). The results of the study were expressed in terms of average cost per patient treated with intravenous/oral ganciclovir and valganciclovir. Results: At 12 months post-transplantation, the incidence rate of CMV infection and disease of high risk transplant patients of both long-term prophylactic regimens were comparableA,B. The average cost per patient treated with valganciclovir and sequential intravenous/oral ganciclovir was 3295.9 € and 3715.51 €, respectively. The higher overall costs of intravenous/oral ganciclovir therapy, compared to oral valganciclovir are due to higher drug administration costs. Conclusions: Long-term prophylaxis with oral valganciclovir is a cost-saving option compared to sequential intravenous/oral ganciclovir with similar efficacy rates, thus the oral therapy is a more efficient strategy in the prevention of CMV infection and disease in solid organ transplantation. APaya et al. American Journal of Transplantation, In press BKletzmayr J et al. Transplantation Vol. 70, 1174-1180, No 9, October 27, 2000