Multinational evaluation of mycophenolic acid, tacrolimus, cyclosporin, sirolimus, and everolimus utilization

Gardiner, Kyle M., Tett, Susan E. and Staatz, Christine E. (2016) Multinational evaluation of mycophenolic acid, tacrolimus, cyclosporin, sirolimus, and everolimus utilization. Annals of Transplantation, 21 1-11. doi:10.12659/AOT.895664

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Author Gardiner, Kyle M.
Tett, Susan E.
Staatz, Christine E.
Title Multinational evaluation of mycophenolic acid, tacrolimus, cyclosporin, sirolimus, and everolimus utilization
Journal name Annals of Transplantation   Check publisher's open access policy
ISSN 1425-9524
Publication date 2016-01-05
Sub-type Article (original research)
DOI 10.12659/AOT.895664
Open Access Status Not Open Access
Volume 21
Start page 1
End page 11
Total pages 11
Place of publication Smithtown, NY, United States
Publisher International Scientific Literature
Collection year 2017
Language eng
Formatted abstract
Background: Increasing immunosuppressant utilization and expenditure is a worldwide challenge as more people successfully live with transplanted organs. Our aims were to characterize utilization of mycophenolate, tacrolimus, cyclosporin, sirolimus, and everolimus in Australian transplant recipients from 2007 to 2013; to identify specific patterns of usage; and to compare Australian utilization with Norwegian, Danish, Swedish, and the Netherlands use.

Material/Methods: Australian utilization and expenditure data were captured through national Pharmaceutical Benefits Scheme and Highly Specialized Drug administrative databases. Norwegian, Danish, Swedish, and the Netherlands utilization were retrieved from their healthcare databases. Utilization was compared as defined daily dose per 1000 population per day (DDD/1000 population/day). Data on kidney transplant recipients, the predominant patient group prescribed these medicines, were obtained from international transplant registries.

Results: From 2007–2013 Australian utilization of mycophenolic acid, tacrolimus and everolimus increased 2.7-fold, 2.2-fold, and 2.3-fold, respectively. Use of cyclosporin and sirolimus decreased 20% and 30%, respectively. Australian utilization was significantly lower than European utilization (2013) but was increasing at a faster rate. Total Australian expenditure increased approximately AUD$30 million over the study period to almost AUD$100 million in2013. Kidney transplantation rates increased across each country over this time, with Australia having the lowest rate.

Conclusions: Immunosuppressant usage and subsequent expenditure are rising in Australia and Northern Europe. With increased numbers of people living with transplants, and the observed growth potential predicted from Northern European data, this class of medicines can be expected to continue consuming an increasing share of Australian pharmaceutical expenditure into the future.
Keyword Drug utilization
Immunosuppressive agents
Kidney transplantation
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ
Additional Notes

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Pharmacy Publications
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Created: Thu, 21 Jan 2016, 16:31:00 EST by Ms Felicity Lindberg on behalf of School of Pharmacy