TOGBI: Transplant Outcomes Using Generic and Brand Name Immunosuppressants

Each year since 2009, more than 28,000 people have received organ transplants in the United States. Immunosuppressive medications are critical to reduce rejection and graft loss in transplant recipients. These medications can be expensive and pose a financial burden to patients, leading to non-adherence. Substituting costly brand name medications with therapeutically equivalent, less expensive generic medications is a potential solution to overcome the financial barrier and improve access and adherence to immunosuppressants. However, there are questions regarding the therapeutic equivalence of generic and brand name immunosuppressants. In addition, generic products have not been compared with each other; thus, there is a concern regarding the substitution of one generic for another generic. This uncertainty is problematic for clinicians who seek to provide the best care for their patients.

This project compares outcomes in kidney and liver transplant recipients receiving generic vs. brand-name immunosuppressants by analyzing data from the Scientific Registry of Transplant Recipients (SRTR), Medicare, and State All-Payer Claims Databases (APCDs) to determine whether generic or brand name immunosuppressants are more effective than the other in preventing rejection and graft failure at the individual patient-level and the transplant program-level. This study makes a significant contribution to the field of transplantation by improving clinical practice and patient care.