The Cost-effectiveness of Valganciclovir Prophylaxis Versus Preemptive Therapy in CMV R+ Kidney Transplant Recipients over the First Year Posttransplantation
| dc.rights.license | open | en_US |
| dc.contributor.author | VILLENEUVE, Claire | |
| dc.contributor.author | REROLLE, Jean-Phillipe | |
| hal.structure.identifier | Immunology from Concept and Experiments to Translation = Immunologie Conceptuelle, Expérimentale et Translationnelle [ImmunoConcept] | |
| dc.contributor.author | COUZI, Lionel | |
| dc.contributor.author | WESTEEL, Pierre-Francois | |
| dc.contributor.author | ETIENNE, Isabelle | |
| dc.contributor.author | ESPOSITO, Laure | |
| dc.contributor.author | KAMAR, Nassim | |
| dc.contributor.author | BÜCHLER, Mathias | |
| dc.contributor.author | THIERRY, Antoine | |
| dc.contributor.author | MARQUET, Pierre | |
| dc.contributor.author | MONCHAUD, Caroline | |
| dc.date.accessioned | 2025-01-25T09:15:38Z | |
| dc.date.available | 2025-01-25T09:15:38Z | |
| dc.date.issued | 2024-08 | |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/204582 | |
| dc.description.abstractEn | Background. In kidney transplant recipients with positive serology (R+) for the cytomegalovirus (CMV), 2 strategies are used to prevent infection, whose respective advantages over the other are still debated. This study aimed to evaluate the cost-effectiveness and cost utility of antiviral prophylaxis against CMV versus preemptive therapy, considering CMV infection-free survival over the first year posttransplantation as the main clinical outcome. Methods. Clinical, laboratory, and economic data were collected from 186 kidney transplant patients CMV (R+) included in the cohort study (85 patients who benefited from CMV prophylaxis and 101 from preemptive therapy). Costs were calculated from the hospital perspective and quality-adjusted life years (QALYs) using the EQ5D form. Using nonparametric bootstrapping, the incremental cost-effectiveness ratio (ICER) and cost utility were estimated (euros) for each case of infection avoided and each QALY gained for 1 y, respectively. Results. Prophylaxis significantly decreased the risk of CMV infection over the first year posttransplantation (hazard ratio 0.22, 95% confidence interval = 0.12-0.37, P < 0.01). Compared with preemptive therapy, prophylaxis saved financial resources (€1155 per patient) and was more effective (0.42 infection avoided per patient), resulting in an ICER = €2769 per infection avoided. Prophylaxis resulted in a net gain of 0.046 in QALYs per patient and dominated over preemptive therapy with €1422 cost-saving for 1 QALY gained. Conclusions. This study shows that CMV prophylaxis, although considered as a more expensive strategy, is more cost-effective than preemptive therapy for the prevention of CMV infections in renal transplant patients. Prophylaxis had a positive effect on quality of life at reasonable costs and resulted in net savings for the hospital. | |
| dc.language.iso | EN | en_US |
| dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
| dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
| dc.title.en | The Cost-effectiveness of Valganciclovir Prophylaxis Versus Preemptive Therapy in CMV R+ Kidney Transplant Recipients over the First Year Posttransplantation | |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1097/TXD.0000000000001678 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Immunologie | en_US |
| dc.identifier.pubmed | 39076520 | en_US |
| bordeaux.journal | Transplantation Direct | en_US |
| bordeaux.page | e1678 | en_US |
| bordeaux.volume | 10 | en_US |
| bordeaux.hal.laboratories | ImmunoConcEpT - UMR 5164 | en_US |
| bordeaux.issue | 8 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | CNRS | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-04911777 | |
| hal.version | 1 | |
| hal.date.transferred | 2025-01-25T09:15:43Z | |
| hal.popular | non | en_US |
| hal.audience | Internationale | en_US |
| hal.export | true | |
| dc.rights.cc | CC BY-NC-ND | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Transplantation%20Direct&rft.date=2024-08&rft.volume=10&rft.issue=8&rft.spage=e1678&rft.epage=e1678&rft.au=VILLENEUVE,%20Claire&REROLLE,%20Jean-Phillipe&COUZI,%20Lionel&WESTEEL,%20Pierre-Francois&ETIENNE,%20Isabelle&rft.genre=article |