Early economic evaluation of chelation therapy in kidney transplant recipients with high-normal lead
Jiasi Hao, Behrooz Z. Alizadeh, Maarten J. Postma, Daan J. Touw, Stephan J. L. Bakker, Lisa A. de Jong
TL;DR
This study evaluates the cost-effectiveness of using chelation therapy with DMSA to remove lead in kidney transplant recipients with high-normal lead levels, finding it could save money and improve health outcomes.
Contribution
The study provides the first early economic evaluation of chelation therapy for kidney transplant recipients with high-normal lead.
Findings
Chelation therapy was found to be cost-saving and improved health outcomes in kidney transplant recipients.
The intervention had a dominant cost-effectiveness ratio with a 60% probability of being cost-effective.
Applying the intervention in the Dutch population could save €27 million in the first five years.
Abstract
Kidney transplant recipients (KTR) with high-normal lead have a higher risk of graft failure (GF). Clinically, chelation therapy using meso-2,3-dimercaptosuccinic acid (DMSA) removes lead. Despite the proposal that chelation therapy can prevent GF through lead removal, evidence is lacking. To guide research efforts, we conducted an early economic evaluation, aiming to explore the economic feasibility of screening for and implementing chelation therapy with oral DMSA for high-normal plasma lead concentrations in KTR (i.e., the intervention) compared to standard of care. A Markov model simulated the life course of 10,000 KTR in the Netherlands from a societal perspective. Transition probabilities were estimated using the data from TransplantLines Food and Nutrition Biobank and Cohort study. Costs and utilities were sourced from publications and public data. Model robustness was…
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Taxonomy
TopicsHeavy Metal Exposure and Toxicity · Trace Elements in Health · Pharmacological Effects and Toxicity Studies