ISSN: 1859 - 2872
An analysis of kidney transplant and post-transplant costs among patients with CYP3A5 *1/*1 and *1/*3 genotypes at 108 Military Central Hospital
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Abstract
Objective: To analyze the cost components and identify factors influencing direct medical costs during kidney transplantation and the post-transplant period among patients with CYP3A5 *1/*1 and *1/*3 genotypes using tacrolimus, from the payer perspective. Subject and method: A retrospective study was conducted on 44 patients from September 2022 to September 2025. Data were collected from medical records and billing statements. Bayesian Model Averaging (BMA) was used to identify factors influencing costs. A p-value < 0.05 was considered statistically significant. Result: Among 44 patients, the CYP3A5 *1/*3 genotype was predominant, accounting for 77%. Treatment costs were highest in the first month after transplantation, ranging from VND 346 to 375 million, and gradually decreased over time. Drug and infusion costs accounted for a large proportion after the first month. Treatment costs during the 6 - 12-month period differed significantly between the CYP3A5 *1/*1 and *1/*3 genotypes (p=0.006). The influencing factors varied across follow-up periods and were not consistent. During the 0 - 1-month period, induction therapy and rejection within 30 days were the strongest factors influencing costs, whereas the CYP3A5 genotype showed a strong influence during the 6 - 12-month period. Conclusion: Treatment costs were highest in the early post-transplant period and declined over time, with significant difference in medical treatment costs during the 6 - 12 month period between CYP3A5 *1/*1 and *1/*3 genotypes. Management of immunological risk, graft rejection complication and long-term follow-up are key factors in optimizing treatment costs in the early post-transplant.
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References
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