Estimación del ahorro hospitalario con el reemplazo de inmunosupresores genéricos en trasplante renal

Background The use of narrow therapeutic index generic immunosuppressant in solid organ transplantation is controversial. Most experiences switching to these drugs have short term follow-up periods, analyze only pharmacokinetic issues and do not systematically include either complications or cost analyses. Aim To analyze the costs and benefits of switching our kidney transplant recipients from innovative tacrolimus to a generic version of the drug. Material and Methods Fifty-seven stable transplant recipients were switched from innovative tacrolimus to a generic version of the drug, maintaining the same dose. They were followed for eight months recording all events during such period. Results We observed two infectious episodes, five allograft biopsies were performed and two patients had acute rejections. Conclusions From the payer’s perspective, if all the costs associated with the change to generic tacrolimus are considered, savings related to a lower cost of the drug translate in a real financial loss for the public health system. The analysis also showed that frequent switches, even from one generic drug to a cheaper one is an even worse strategy to save money.