OBJECTIVES: To systematically review the methodological approaches in published cost effectiveness models of Immunosuppressant approved as maintenance therapies used in kidney transplantation patients.
METHODS: A systematic literature search from different databases with an end date of December 18, 2017 was completed. The search was limited to English studies, cost effectiveness models comparing, immunosuppressant drugs approved as maintenance therapies used in kidney transplantation and those reporting quality adjusted life years. The quality of reporting the models was performed by using CHEERS statement.
RESULTS: The initial search for title and abstract screening resulted in 903 articles. 7 economic evaluation studies were included in the final review. The reporting quality scores of most articles were rated as acceptable, between 61% and 100%. Of the included 7 studies, only 1 was done in the USA. All studies (100%) were modeled for adult age range between 43 and 50 years old. Only 2 studies (28%) evaluated standard of care versus Belatacept. All studies defined their health states by the existence or absence of functioning graft. No studies took the societal prospective. The time horizons varied, but 57% of studies used a lifetime horizon. Fifty seven percent of studies identified that maintaining graft function assumption and time horizon as the most sensitive and influential parameters. Forty two percent of studies did not conduct any model validation.
CONCLUSIONS: Cost effectiveness models of Immunosuppressant had different modeling approaches and quality levels. Future cost effectiveness models should consider evaluating Belatacept in USA because no cost-effectiveness studies have addressed USA population in which the use of Belatacept is rising. Also, future models should include comorbidities in the model, since some studies have claimed that comorbidities may affect drug responses.
