This paper is only available as a PDF. To read, Please Download here.
Abstract
The objectives of this study were: (1) to compare total hospital charges for a sample
of cadaveric renal transplant patients categorized according to the type of induction
therapy used (Orthoclone OKT®3 Sterile Solution or Atgam® Sterile Solution); (2) to
compare specific charge categories between the two groups; and (3) to examine the
relationship between charges and a set of independent variables. A retrospective review
was conducted of hospital charges associated with a sample of renal transplant patients.
The overall sample for this study comprised 510 patient discharges from 22 hospitals
in the United States. Comparisons between the OKT3 and Atgam groups were made for
total and specific charge categories using two different approaches to help control
variations in charges that were not related to the type of induction therapy used.
The first approach consisted of t test or chi-square comparisons between the groups for subsets of observations that
had been identified in a stepwise fashion. These judgment samples were defined to
remove sources of variation in charges other than those resulting from the type of
induction therapy selected. The second approach used multiple linear regression analysis
to help statistically control variation in charges from other sources. The results
showed that higher drug charges in the Atgam group were offset by lower charges in
other categories (P < 0.05). These findings suggest that hospital formulatory committees should consider
all relevant costs, not just drug acquisition costs, when selecting products. However,
further investigation is warranted to explore differences in charges due to: (1) between-hospital
variation; (2) patients' severity of illness before receiving induction therapy; and
(3) differences in side-effect profiles for the two induction therapies.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical TherapeuticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Cyclosporin—A pharmacoeconomic evaluation of its use in renal transplantation.PharmacoEconomics. 1993; 4: 366-395
- Solid organ transplantation.Am Pharm. 1994; NS34: 59-69
- Immunosuppressive drugs in renal transplantation.Drugs. 1992; 44: 554-566
- A randomized clinical trial of induction therapy with OKT3 in kidney transplantation.Transplantation. 1993; 55: 44-50
- Renal transplantation.NEJM. 1994; 331: 365-376
- Cyclosporin in renal transplantation: Pharmacoeconomic data support clinical practice but many questions remain.Drug Ther Perspect. 1994; 4 (Anonymous): 1-4
- A pharmacoeconomic analysis of IV H2-receptor antagonist use in 40 hospitals.Hosp Formul. 1994; 29: 379-391
- Cytokine nephropathy during antilymphocyte therapy.Transplant Proc. 1993; 25 (Suppl 1): 27-30
- Acute pulmonary insufficiency due to OKT3 therapy.Transplant Proc. 1990; 22: 1779-1781
- Is sequential use of ALG and OKT3 in renal transplants associated with an increased incidence of fulminant posttransplant lymphoproliferative disorder?.Transplant Proc. 1991; 23: 1106-1107
- Complications of using OKT3 for induction of immunosuppression in recipients of kidneys from non-heart beating donors.Transplant Proc. 1994; 26: 3123-3125
- Adverse events associated with OKT3 immunosuppression in the prevention or treatment of allograft rejection.Clin Transplant. 1993; 7: 431-446
- Complement activation during OKT3 treatment: A possible explanation for respiratory side effects.Kidney Int. 1993; 43: 1140-1149
- Potentials and limitations of database research illustrated by the QMMP AMI Medicare Mortality Study.Stat Med. 1991; 10: 637-646
- The role of insurance claims databases in drug therapy outcomes research.PharmacoEconomics. 1993; 4: 323-330
- 2nd ed. A Second Course in Business Statistics: Regression Analysis. Dellen Publishing Company, San Francisco1986: 5-83
- Collinearity, power, and interpretation of multiple regression analysis.J Market Res. 1991; 28: 268-280
Article info
Identification
Copyright
© 1995 Published by Elsevier Inc.
