Tacrolimus Utilization and Expenditure in Serbia

Abstract

BackgroundIncreasing immunosuppressant consumption and expenditure is a quite a challenge in transplantation medicine. The aim of the study was to characterize the utilization and expenditure of tacrolimus, backbone, and standard of care in immunosuppression regimen in Serbian solid organ transplant recipients.MethodsThis study was performed as retrospective cross-sectional study during a 3-year period (from 2013 to 2015) in Serbia. The Anatomical Therapeutic Chemical Classification/Defined Daily Doses (ATC/DDD) international system was used for consumption evaluation.ResultsTwo hundred and sixty-nine patients were transplanted in Serbia from 2013 to 2015 (185 recipients from deceased donors and 84 recipients from living donors). Total number of deceased donors in this period was 81. The consumption of tacrolimus increased (from 0.051 DDD/1,000 inhabitants/day to 0.069 DDD/1,000 inhabitants/day in 2013 and 2015, respectively). The total cost of tacrolimus was also increased; from 1,206,816€ to 1,483,472€ in 2013 and 2015, respectively. On the other hand, the number of all new solid organ transplants (from deceased and living donors) per million population per year was decreased from 17.39 to 10.02, from 2013 to 2015, respectively.ConclusionIn spite downward trend in the number of solid organ transplants, tacrolimus consumption and expenditure in the examined 3-year period in Serbia increased. Since tacrolimus is a high-cost and life-preserving drug, its increasing utilization and expenditure will most likely continue consuming an enhancing share of Serbian pharmaceutical expenditure, as well as its health care, as a whole.

Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices

“…The greatest graft life years of young donor organs is transplantation into younger recipients and is associated with cost savings [7]. Allocating elderly donor kidneys to younger recipients results in higher graft failure rates, increasing the flow of patients back to an already-burdened waiting list.…”

Deceased donor kidney allocation: an economic evaluation of contemporary longevity matching practices

“…The greatest graft life years of young donor organs is transplantation into younger recipients and is associated with cost savings (7) . Allocating elderly donor kidneys to younger recipients results in higher graft failure rates, increasing the ow of patients back to an already-burdened waiting list.…”