Each year since 2009, more than 28,000 people have received organ transplants in the United States. Immunosuppressive medications are critical to reducing 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. This uncertainty is problematic for clinicians who seek to provide the best care for their patients.

This project compared uptake of generic immunosuppressants by state in kidney and liver transplant recipients by analyzing data from the Scientific Registry of Transplant Recipients (SRTR), Medicare, and the Colorado All-Payer Claims Database (APCD), and provided information on cost savings to Medicare and to patients. This study also made a significant contribution to the field of statistical modeling.