Cost-minimization analysis of immunoglobulin treatment of primary immunodeficiency diseases in Spain

Autores de IIS La Fe

• Pedro Moral Moral

  Autor

Participantes ajenos a IIS La Fe

• Alsina L
• Bruno Montoro, J.
• Neth O
• Ortiz Pica, Marta
• Sánchez-Ramón S
• Presa M
• Oyagüez I
• Angel Casado, Miguel
• Ignacio Gonzalez-Granado, Luis

Grupos

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

  Investigador establecido

  Marta Montero Alonso

Abstract

Primary immunodeficiency diseases (PID), which are comprised of over 400 genetic disorders, occur when a component of the immune system is diminished or dysfunctional. Patients with PID who require immunoglobulin (IG) replacement therapy receive intravenous IG (IVIG) or subcutaneous IG (SCIG), each of which provides equivalent efficacy. We developed a cost-minimization model to evaluate costs of IVIG versus SCIG from the Spanish National Healthcare System perspective. The base case modeled the annual cost per patient of IVIG and SCIG for the mean doses (per current expert clinical practice) over 1 year in terms of direct (drug and administration) and indirect (lost productivity for adults and parents/guardians of pediatric patients) costs. It was assumed that all IVIG infusions were administered in a day hospital, and 95% of SCIG infusions were administered at home. Drug costs were calculated from ex-factory prices obtained from local databases minus the mandatory deduction. Costs were valued on 2018 euros. The annual modeled costs were €4,266 lower for patients with PID who received SCIG (total €14,466) compared with those who received IVIG (total €18,732). The two largest contributors were differences in annual IG costs as a function of dosage (- €1,927) and hospital administration costs (- €2,688). However, SCIG incurred training costs for home administration (€695). Sensitivity analyses for two dose-rounding scenarios were consistent with the base case. Our model suggests that SCIG may be a cost-saving alternative to IVIG for patients with PID in Spain.

© 2021. The Author(s).

Keywords

• Cost-minimization analysis, Immune system, Immunoglobulin replacement therapy, Intravenous immunoglobulin, Primary immunodeficiency disease, Subcutaneous immunoglobulin