ASSESSMENT OF THE FREQUENCY AND COSTS OF POSTTRANSPLANTATION HOSPITALIZATIONS IN PATIENTS RECEIVING TACROLIMUS VERSUS CYCLOSPORINE

We assessed the frequency and costs of hospitalizations in patients re ceiving tacrolimus (FK506) compared with patients receiving cyclospori ne A for immunosuppression during 1 year after kidney transplantation. Four hundred twelve cadaveric kidney transplant recipients were rando mized onto a phase III, prospective, multicenter, clinical trial. Hosp ital billing data were collected for 1 year posttransplantation, Total inpatient costs were calculated from billed charges and standardized to 1995 US dollars. Medical resource utilization rates and inpatient c osts were compared between treatment groups using unpaired Student's t -tests, Complete billing data (transplantation and all posttransplanta tion hospitalizations) were available for 65% (268 of 412) of the stud y patients. Among tacrolimus and cyclosporine patients with complete b illing data, the rates of allograft rejection were 32% and 47%, respec tively (P = 0.009), and the rates of rehospitalization during the year after transplantation were 53% and 63%, respectively (P = 0.080). The mean per-episode rehospitalization costs were significantly lower amo ng tacrolimus-treated patients compared with cyclosporine-treated pati ents ($7,495 v $11,497; P = 0.031), and the mean total rehospitalizati on costs were significantly lower in the tacrolimus group compared wit h the cyclosporine group (S8,550 v $14,869; P = 0.029). In addition, t he total 1-year hospitalization costs (including transplantation and p osttransplantation hospitalizations) were significantly lower in the t acrolimus group compared with the cyclosporine group ($53,435 v $61,19 1; P = 0.046). Compared with cyclosporine-based immunosuppression, tac rolimus-based immunosuppression for kidney transplant recipients was a ssociated with a significantly lower rate of rejection, which was asso ciated with significantly lower per-episode rehospitalization costs, l ower total 1-year rehospitalization costs, and lower total 1-year hosp italization costs. (C) 1998 by the National Kidney Foundation, Inc.