The Adoption of Generic Immunosuppressant Medications Among Kidney and Liver Transplant Recipients Using the Colorado All Payer Claims Database.
1Arbor Research Collaborative for Health, Ann Arbor, MI
2U of Michigan, Ann Arbor, MI
3Food and Drug Administration, Silver Spring, MD
4U of Virginia, Charlottesville, VA
Meeting: 2017 American Transplant Congress
Abstract number: B158
Keywords: Immunosuppression, Kidney, Liver, Pharmacoeconomics
Session Information
Session Name: Poster Session B: Kidney Complications II
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background: Substitution of generic for brand-name immunosuppressants has increased in solid organ transplantation following the expiration of brand patents. Our aim was to describe the patterns of brand vs. generic immunosuppressant use among kidney and liver transplant recipients.
Methods: The Scientific Registry of Transplant Recipients database was used to identify kidney and liver recipients transplanted between 2009 and 2013 and linked to the Colorado All Payer Claims Database to identify generic and brand immunosuppressant use from January 2009 through September 2014. Percentages of patients using brand and generic tacrolimus (TAC), mycophenolate mofetil (MMF), and mycophenolate sodium (MPS) were plotted by month to illustrate trends over time.
Results: Among 582 kidney transplant recipients, 544 (93%), 234 (40%) and 346 (59%) received TAC, MMF, and MPS, respectively; 193 of 203 (95%) liver transplant recipients were on TAC. In the kidney cohort, generic TAC use increased to 74% within one year of the first generic approval by the FDA (August 2009) and to 85% by the end of the second year. TAC trends were similar in the liver cohort. Among kidney recipients, usage of generic formulations increased to 88% within a year for MMF and to 65% within 9 months for MPS after the transition to generics began.
Conclusion: The use of generic immunosuppressants in transplantation increased rapidly after the introduction of the first few generics and has greatly exceeded brand usage. Generic TAC uptake was more gradual than that of MMF and MPS. This difference in practice may have been a consequence of providers' hesitancy to switch to generic TAC due to a perceived narrower therapeutic window resulting in greater apprehension regarding the efficacy of the generic formulation.
CITATION INFORMATION: Liu Q, Smith A, Park J, Oguntimein M, Dutcher S, Bello G, Helmuth M, Turenne M, Balkrishnan R, Fava M, Sharma P, Beil C, Leichtman A, Zee J. The Adoption of Generic Immunosuppressant Medications Among Kidney and Liver Transplant Recipients Using the Colorado All Payer Claims Database. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Liu Q, Smith A, Park J, Oguntimein M, Dutcher S, Bello G, Helmuth M, Turenne M, Balkrishnan R, Fava M, Sharma P, Beil C, Leichtman A, Zee J. The Adoption of Generic Immunosuppressant Medications Among Kidney and Liver Transplant Recipients Using the Colorado All Payer Claims Database. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/the-adoption-of-generic-immunosuppressant-medications-among-kidney-and-liver-transplant-recipients-using-the-colorado-all-payer-claims-database/. Accessed March 24, 2023.« Back to 2017 American Transplant Congress