Table 2.

Cost-effectiveness analysis of Medicare’s immunosuppressive drug coverage for lifetime versus current policy or others

Yen et al. (27)Gustafsson et al. (29)Page and Woodward (28)
Publication year200420052008–2009
Data sourceUSRDS/MedicareUS Congressional Budget OfficeUSRDS/Medicare
Research period1995–19992000–20041995–2003
Policy comparisonLifetime versus current policyLifetime versus current policyAll versus lowest-income quartile recipients
AnalysisFuture projections on retrospective estimatesFuture projections on retrospective estimatesRetrospective estimates
Estimated graft survival benefit with lifetime policy (%/yr or number of grafts saved)1.2%/yr2.4%/yrAll covered: 408; only lowest income covered: 186 (between 2000 and 2002)
Average cost of immunosuppressive drugs ($/yr)13,70011,8008000
Cost of graft failure, first year ($)135,00067,70052,800
ICER per graft failure avoided91,000Not reportedAll: 2000=$23,300, 2001=$56,700, 2002=$72,700; lowest income: 2000=−$4,700, 2001=−$12,000, 2002=−$15,400
Societal saving ($ million/yr)136−100 between 2000 and 2004 and neutral between 2006 and 2015 (if estimated graft survival benefit is 2.4%/yr)All: 2000=−2.4, 2001=−7.8, 2002=−12.5; lowest income: 2000=0.24, 2001=0.78, 2002=1.08
Recommendation on lifetime coverage for kidney transplant recipientsAllAll (conditioned on graft survival benefit)At least to lowest-income quartile recipients
  • USRDS, US Renal Data System; ICER, incremental cost-effectiveness ratio.