Evaluation of the cost-effectiveness of Sirolimus versus cyclosporin for immunosuppression after renal transplantation in the United Kingdom

Over a 10-year time horizon, treatmentwith sirolimus was projected to produce a gain of 0.60 discounted year of functioning graft with a cost savings of £276 per patient. Over a 20-year time horizon these benefits increased to 1.59 discounted years of functioning graft and a cost savings of 7405 per patient. Using sensitivity analysis of the 10-year model, the only factors found to cause the probability of exceeding a £30,000 ceiling to be >5% were the proportion of subjects maintaining continuous graft function and the use of low-dose cyclosporin. With the 20-year model, sirolimus maintained cost-effectiveness across most scenarios in sensitivity analysis. Conclusions: In this model analysis, sirolimus was cost-effective compared with cyclosporin for 10 to 20 years after renal transplantation in the United Kingdom, from the perspective of the UK National Health Service and Personal Social Service.