Economic evaluation of renal replacement therapies and immunosuppressants of renal transplantation

The thesis presents a comprehensive overview on the economic evaluation of renal replacement therapies and immunosuppressants for renal transplantation, mainly based upon the results of a Markov model developed by the author.;Renal transplantation is more cost-effective than dialysis in the treatment of patients with end-stage renal disease (ESRD). Consequently renal transplantation should be applied for all ESRD patients if there is an available organ for transplantation and the surgery is not contraindicated for medical-professional reasons.;The increasing social and economic burden of dialysis can be reduced by increasing the number of organs available for transplantation, and by extending the survival of transplanted allografts.;Several organ donation programmes have been developed to address the first objective. The widespread introduction of these programmes would result in significant health gain for ESRD patients and cost-savings for the society and health care payers.;An objective method is depicted in the thesis to answer the dilemma how long waiting for an ideal donor results in equal health gain with an immediate transplantation of a marginal allograft from an extended criteria donor.;Finally the thesis summarizes the economic issues of improving the graft survival by better posttransplant care and modern immunosuppressants. Pharmaceutical manufacturares with an interest in the field of transplantation need to invest more and more into the early phase pharmacoeconomic modelling of new drug candidates, as they must demonstrate the cost-effectiveness of their new immunosuppressants at launch. Failing to do so, no reimbursement is granted to the new drug, and so its market access remains restricted.;The presented results are highly important from the health political and industrial political point of view. Similar approaches and methods should also be applied to other fields of health care and other therapeutic areas.