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Kateir Contreras1, María José Vargas, Paola García

  • 1Unidad de Nefrología, Servicio de Medicina Interna, Hospital Universitario San Ignacio, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, D.C., Colombia. kamacovi@gmail.com.

Biomedica : Revista Del Instituto Nacional De Salud
|April 19, 2018
PubMed
Summary

Universal valganciclovir prophylaxis is more cost-effective than preemptive treatment for preventing cytomegalovirus infection in Colombian kidney transplant patients. This strategy also reduces infection risk, making it the preferred approach for intermediate-risk individuals.

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Area of Science:

  • Nephrology
  • Infectious Diseases
  • Health Economics

Background:

  • Cytomegalovirus (CMV) infection is a common complication in kidney transplant recipients.
  • Two primary prevention strategies exist: universal prophylaxis with valganciclovir or preemptive treatment based on viral load.
  • Patients with intermediate risk (donor positive/recipient positive or donor negative/recipient positive) require careful management.

Purpose of the Study:

  • To compare the cost-effectiveness of universal valganciclovir prophylaxis versus preemptive treatment for CMV infection in intermediate-risk kidney transplant patients in Colombia.

Main Methods:

  • A decision tree model was developed from a third-party payer perspective.
  • Direct medical costs in Colombian pesos (COP) for 2014 were analyzed over one year.
Keywords:
Colombiacitomegaloviruscostos y análisis de costoinmunosupresiónprevención de enfermedadestrasplante de riñón

Related Experiment Videos

  • Transition probabilities were derived from clinical studies and Delphi method expert validation.

    • Main Results:

    • Universal valganciclovir prophylaxis was found to be less expensive and associated with a lower probability of infection.
    • The average first-year cost for preemptive treatment was COP$ 30,961,290, compared to COP$ 29,967,834 for universal prophylaxis.
    • Universal prophylaxis demonstrated an 'incremental' cost saving of COP$ 993,456.

    Conclusions:

    • Universal prophylaxis with valganciclovir is the optimal strategy for intermediate-risk kidney transplant patients in Colombia.
    • This approach is more cost-effective and reduces the risk of cytomegalovirus infection.