HOPE Center Compares the Cost-Effectiveness of Tacrolimus Formulations in Kidney Transplant Subgroups

(July 22, 2021)

College of Pharmacy and HOPE Center investigators JASON HURWITZ, MS, PhD,  and AMY GRIZZLE, PharmD, co-authored a new study in the Journal of Managed Care and Specialty Pharmacy titled Cost-effectiveness of once-daily vs twice-daily tacrolimus among Hispanic and Black kidney transplant recipients. 

The researchers assessed benefits of once daily extended-release Tacrolimus tablets in patient subpopulations that are rapid metabolizers, specifically Black and Hispanic populations. Once daily extended-release tablets have been shown to be effective in these subgroups however are more costly than twice daily administration. A decision analytic model was developed from a US payers perspective with a primary outcome of cost per successfully treated patient. Overall results showed that once-daily extended-release Tacrolimus tablets were incrementally more costly and more effective than twice-daily immediate-release therapy. The incremental cost-effectiveness ratio (ICER) for using once daily extended-release tablets over twice daily immediate-release therapy during the first year of treatment in the Hispanic group was $65,643 per additional successfully treated patient. The ICER for the Black group was $90,458. Treatment in both populations appears cost-effective when weighed against the costs of treating graft loss, resuming dialysis indefinitely, and potential retransplant. This study provides a foundation for further research to update and expand inputs as more data become available to improve real-world relevance and decision making. Collaborating with researchers from several Universities was a really positive experience as Principle Investigator, Jason Hurwitz shared, “Having the opportunity for us to continue working with former colleague, Dan Malone, and alumnus, Lorenzo Villa Zapata, provided the perfect blend of teamwork for this project. We also appreciated the opportunity to welcome pharmacy students, Zufan Yegezu and Brooke Tavares, to help with our study as they learned how to use the HCUP database to identify hospitalization costs associated with serious adverse events.” Co-author, DANIEL MALONE, PhD is retired from the UA College of Pharmacy and currently on faculty with the University of Utah College of Pharmacy. At the time of the study, LORENZO VILLA ZAPATA, PhD Lorenzo Villa Zapata was a post-doctoral student collaborating with the HOPE Center and is now on faculty at Mercer University in Atlanta Georgia.