{"doi":"10.1111/ctr.13813","title":"Economic impacts of alternative kidney transplant immunosuppression: A national cohort study","abstract":"Understanding the economic implications of induction and maintenance immunosuppression (ISx) is important in developing personalized kidney transplant (KTx) care. Using data from a novel integrated data set including financial records from the University Health System Consortium, Medicare, and pharmacy claims (2007-2014), we estimated the differences in the impact of induction and maintenance ISx regimens on transplant hospitalization costs and Medicare payments from KTx to 3 years. Use of thymoglobulin (TMG) significantly increased transplant hospitalization costs ($12 006; P = .02), compared with alemtuzumab and basiliximab. TMG resulted in lower Medicare payments in posttransplant years 1 (-$2058; P = .05) and 2 (-$1784; P = .048). Patients on steroid-sparing ISx incurred relatively lower total Medicare spending (-$10 880; P = .01) compared with patients on triple therapy (tacrolimus, antimetabolite, and steroids). MPA/AZA-sparing, mammalian target of rapamycin inhibitors-based, and cyclosporine-based maintenance ISx regimens were associated with significantly higher payments. Alternative ISx regimens were associated with different KTx hospitalization costs and longer-term payments. Future studies of clinical efficacy should also consider cost impacts to define the economic effectiveness of alternative ISx regimens.","journal":"Clinical Transplantation","year":2020,"id":107877,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9482,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":242619,"name":"Yaşar Çalışkan","orcid":"0000-0003-3816-8047","position":1,"is_corresponding":false},{"id":320235,"name":"Mark A. Schnitzler","orcid":"0000-0001-8547-5643","position":2,"is_corresponding":false},{"id":455635,"name":"Huiling Xiao","orcid":null,"position":3,"is_corresponding":false},{"id":388576,"name":"Vikas R. Dharnidharka","orcid":"0000-0001-8000-1385","position":4,"is_corresponding":false},{"id":257567,"name":"Dorry L. Segev","orcid":"0000-0002-1924-4801","position":5,"is_corresponding":false},{"id":257566,"name":"Mara McAdams‐DeMarco","orcid":"0000-0003-3013-925X","position":6,"is_corresponding":false},{"id":473109,"name":"Daniel C. Brennan","orcid":"0000-0002-4818-7455","position":7,"is_corresponding":false},{"id":517728,"name":"Henry B. Randall","orcid":"0000-0003-4075-2605","position":8,"is_corresponding":false},{"id":270993,"name":"Tarek Alhamad","orcid":"0000-0003-4289-0817","position":9,"is_corresponding":false},{"id":303932,"name":"Bertram L. Kasiske","orcid":"0000-0003-4809-6956","position":10,"is_corresponding":false},{"id":454505,"name":"Gregory P. Hess","orcid":"0000-0001-8942-6865","position":11,"is_corresponding":false},{"id":270991,"name":"Krista L. Lentine","orcid":"0000-0002-9423-4849","position":12,"is_corresponding":false},{"id":320242,"name":"David A. Axelrod","orcid":"0000-0001-5684-0613","position":0,"is_corresponding":true}],"reference_count":31,"raw_metadata":null,"created_at":"2026-07-18T23:12:39.385256Z","pmid":"32027049","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}