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A Model to Explore the PotentialBudgetImpactof a Novel ScreeningTool forthe Detectionof
Subclinical RejectionAmongKidneyTr...
A Model to Explore the Potential Budget Impact of a Novel Screening Tool for the Detection of Subclinical Rejection Among ...
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A Model to Explore the Potential Budget Impact of a Novel Screening Tool for the Detection of Subclinical Rejection Among Kidney Transplant Patients

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A Model to Explore the Potential Budget Impact of a Novel Screening Tool for the Detection of Subclinical Rejection Among Kidney Transplant Patients

  1. 1. A Model to Explore the PotentialBudgetImpactof a Novel ScreeningTool forthe Detectionof Subclinical RejectionAmongKidneyTransplantPatients. K. Jaglinski,1 H.Uchida,1 T. Inocencio,2 K.Hughes.2 1 Immucor, Inc, Waukesha, WI 2 Avalare Health, LLC, Washington, DC. Background: Acute rejectionamongkidneytransplantpatientsiscommon,with~10% of individuals experiencingacute rejectionwithinthe firstyearandrisingto16-17% at five years.Routine monitoring includesserumcreatinine levels,butthisisconsideredtobe nonspecificforacute rejectionandisonly detectedaftersubstantialdamage hasoccurred.The KidneySolidOrganResponse Test(kSORT) assayis a non-invasive molecularassaythatmeasuresblood-basedgenemarkersfortransplantedkidney rejection.Inthe Acute RejectioninRenal Transplantation(AART) study,acute rejectionwasdetectedby kSORT upto 3 monthsbefore detectionbybiopsy,givingprovidersanearlieropportunitytomodify immunosuppressiontopreventsubsequentrejection.The objectiveof thisanalysisistoevaluate the potential budgetimpactof the kSORTassayfor rejectionsurveillancefromacommercial payer perspective. Methods:A 2-yearexploratorysemi-Markovcohortmodel withmonthlycycleswasconstructedto model the relationshipbetweensubclinical rejection(SCR),acute cellularrejection(ACR),andgraft failure (GF).Fourseparate Markovmodelsrepresentnomonitoring,monitoringwithprotocol biopsy(PB) only,monitoringwithkSORTonly,andmonitoringwithPBandkSORT,while incorporating the monthsduringwhicha patientreceivesthe respective monitoringtool (i.e.,kSORT,PB,orboth). Results:In the base case scenario,kSORTisexpectedtoproduce abudgetimpactof $0.0057 per memberpermonth(PMPM) duringthe firstyear and$0.0058 PMPM duringthe secondyear. Conclusions:Thismodel indicatesthatthe kSORTassayisexpectedtoproduce minimal budgetimpact to payers.The low budgetimpactisattributedtothe small patientpopulationwithinplanswithrenal transplantseveryyear,inadditiontorelativelylow acute rejectionandgraftfailure rates.Althoughthe budgetimpactissmall,additional clinical datashowinghow kSORTimprovespatientoutcomesare needed.Long-termdatamaybe of particularimportinshowingtrue value of the technology. CITATION INFORMATION: Jaglinski K, Uchida H, Inocencio T, HughesK. A Model to Explore the Potential Budget Impact ofa Novel Screening Tool for the Detectionof Subclinical RejectionAmong KidneyTransplant Patients. Am J Transplant. 2016;16 (suppl 3).

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