2 APPROACHES TO COMPARING HOSPITAL CHARGES BETWEEN CADAVERIC RENAL-TRANSPLANT PATIENTS WHO RECEIVED ORTHOCLONE OKT(R)3 STERILE SOLUTION OR ATGAM(R) STERILE SOLUTION FOR INDUCTION THERAPY

The objectives of this study were: (1) to compare total hospital charg es for a sample of cadaveric renal transplant patients categorized acc ording to the type of induction therapy used (Orthoclone OKT(R)3 Steri le Solution or Atgam(R) Sterile Solution); (2) to compare specific cha rge categories between the two groups; and (3) to examine the relation ship between charges and a set of independent variables. A retrospecti ve review was conducted of hospital charges associated with a sample o f renal transplant patients. The overall sample for this study compris ed 510 patient discharges from 22 hospitals in the United States. Comp arisons between the OKT3 and Atgam groups were made for total and spec ific charge categories using two different approaches to help control variations in charges that were not related to the type of induction t herapy used. The first approach consisted of t test or chi-square comp arisons between the groups for subsets of observations that had been i dentified in a stepwise fashion. These judgment samples were defined t o remove sources of variation in charges other than those resulting fr om the type of induction therapy selected. The second approach used mu ltiple linear regression analysis to help statistically control variat ion in charges from other sources. The results showed that higher drug charges in the Atgam group were offset by lower charges in other cate gories (P < 0.05). These findings suggest that hospital formulary comm ittees should consider all relevant costs, not just drug acquisition c osts, when selecting products. However, further investigation is warra nted to explore differences in charges due to: (1) between-hospital va riation; (2) patients' severity of illness before receiving induction therapy; and (3) differences in side-effect profiles for the two induc tion therapies.