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Farmacia Hospitalaria

On-line version ISSN 2171-8695Print version ISSN 1130-6343

Abstract

PLASENCIA-GARCIA, Inmaculada et al. Clinical-economic impact of the change of protocol for use of basiliximab in liver transplant. Farm Hosp. [online]. 2019, vol.43, n.1, pp.13-18. ISSN 2171-8695.  https://dx.doi.org/10.7399/fh.11036.

Objective:

Evaluation of the clinical and economic impact after the protocol change of basiliximab use in orthohepatic transplant.

Method:

Retrospective study in which all liver transplant patients were included during the years 2013, 2014 and until February 15, 2015. The study was divided into two stages according to the protocol used: 1) administration of basiliximab only if factors of previous risk, and 2) administration of the first dose of basiliximab to all transplant patients and the second dose if it had risk factors.

Results:

83 patients were included, 34 according to protocol 1 and 49 according to protocol 2. No significant differences were found in the clinical variables evaluated or in the variables related to health outcomes. Considering that the percentage of patients without risk factors who received basiliximab was 43% and without differences in the stays, we could estimate an additional cost for the universal use of basiliximab in orthohepatic transplant of € 21,400.00.

Conclusions:

In our population, the protocol change making universal the first dose of basiliximab has not shown the expected benefits, but an increase in costs, so the suitability of the new protocol in consensus with the medical team must be reconsidered. The evidence regarding the use of basiliximab in orthohepatic transplant remains limited and although its benefit seems clear in patients with risk factors, especially renal failure, recommendations about its use universally remains controversial.

Keywords : Basiliximab; Costs and benefits; Immunosuppression; Liver transplantation; Renal failure.

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