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versión impresa ISSN 0120-4157


CONTRERAS, Kateir et al. Cost-effectiveness of two prevention cytomegalovirus infection schemes in renal transplant patients at intermediate risk in Colombia. Biomédica [online]. 2018, vol.38, n.1, pp.77-85. ISSN 0120-4157.


Cytomegalovirus (CMV) is the most frequent opportunistic infection after renal transplantation. There are two strategies for its prevention: Universal prophylaxis, with valganciclovir for 90 days, and anticipated therapy, using weekly viral load surveillance, and therapy only if positive. Meta-analysis directly comparing both strategies have shown them to have similar effectiveness.


To determine which strategy is more cost-effective in intermediate risk patients in Colombia.

Materials and methods:

We designed a third-party payer perspective decision tree, considering only direct medical costs in 2014 Colombian pesos (COP) (USD$ 1=COP$ 2,000) and a time horizon of one year. The target population was intermediate CMV risk patients (positive receptor). Transition probabilities were extracted from clinical studies, validated with a Delphi expert panel method; procedural costs were obtained from the ISS 2001 manual with a 33% increment based on the Consumer Price Index for 2014, while medication costs were obtained from the official Ministry of Health information system.


Universal prophylaxis with valganciclovir was dominant, with lower costs and less probability of infection. The average cost of the first year in anticipated therapy would be COP$ 30,961,290, whereas in the case of universal therapy the cost would be COP$ 29,967,834 (incremental cost of COP$ 993,456).


For Colombian renal transplant patients at intermediate risk for CMV infection, universal prophylaxis strategy is the best option.

Palabras clave : Cytomegalovirus; costs and cost analysis; kidney transplantation; disease prevention; immunosuppression; Colombia.

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