Economic implications of the use of Basiliximab in addition to triple immunosuppressive therapy in renal allograft recipients: a UK perspective

Objective: To compare resource use and costs in renal transplant recipients treated with basiliximab or placebo plus triple immunosuppressive therapy. Design: International randomised, double-blind, placebo-controlled trial; economic evaluation undertaken alongside the efficacy trial. The economic evaluation was performed from a UK National Health Service hospital perspective.</p> Setting: 31 centres in 12 countries. Participants: 345 renal transplant recipients were enrolled; 340 were randomised (basiliximab 168; placebo 172) and included in the intention-to-treat analysis. Intervention: Treatment with placebo or basiliximab (20mg intravenous bolus) on day 0 and day 4 after transplantation. Main outcome measures: Resource utilisation in multiple categories and treatment costs for basiliximab and placebo-treated patients during the 6-month post-transplantation period. Results: No statistically significant differences were found in any of the economically important categories of resource use or in the mean cost of treatment per person across the whole trial. The mean cost of treatment, including the cost of basiliximab, was £16 095 for basiliximab recipients and £15 864 (1997/1998 costs) for placebo recipients, a mean difference of £231 (95%; CI: -£1983 to £2446), which was not significant. Basiliximab treatment led to a significant reduction in acute rejection episodes (basiliximab 20.8%; placebo 34.9%; p = 0.005). Conclusions: Basiliximab therapy confers a significant clinical benefit to renal transplant recipients without increasing overall treatment costs.