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A retrospective evaluation was performed comparing the cost-effectiveness of mycophenolate mofetil (MMF), N=33, to a historical azathioprine (AZA) cohort, N=43, as part of a triple immunosuppression regimen for the first 6 months after primary cadaveric renal transplant. In addition to the costs of the initial hospitalization, the primary endpoints for the analysis were the costs associated with the incidence and severity of rejection as well as infectious episodes and adverse drug events. The analysis was from the health-system perspective. The initial length of hospitalization was not significantly different between the two groups (MMF 12.7d vs AZA 13.7d). The overall incidence of rejection and the incidence of moderate or severe rejection was significantly lower in the MMF group (12.1%/6.1%), as compared to the AZA group (42.9%/34.9%), p=0.045 and 0.024, respectively. The average cost per resection in each group was $5,715 for the MMF patients and $24,079 m the AZA patients. The overall incidence of patients with infectious episodes was similar in the two groups (64% vs. 67%), as was the average cost per episode ($2,118 vs. $2,569), respectively. Graft survival was slightly higher in the MMF group (97%), compared to the AZA patients (88%), however, 61 outpatient dialysis days were required for MMF patients versus 186 for the patients in the azathioprine group with an associated cost of $18,900 and $58,590, respectively, in each group. Patient survival was 100% in the MMF group and 97% in the AZA group. The six month cost evaluation (including the cost of each medication) using Decision Analysis by TreeAge (DATA) demonstrated an overall cost savings, of $10,051 (p= 0.014) for the patients receiving MMF compared to those treated with AZA. This data supports that MMF is cost-effective in comparison to AZA in the first 6 months after kidney transplantation.