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

Fecha de publicación: 01/09/2021 Fecha Ahead of Print: 01/09/2021

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

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.

Datos de la publicación

ISSN/ISSNe:: 1618-7598, 1618-7601
Tipo:: Article
Páginas:: 551-558
DOI:: 10.1007/s10198-021-01378-x
PubMed:: 34546485
Factor de Impacto:: 0,873 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Métricas

Filiaciones

Alsina L:: 1 Clinical Immunology and Primary Immunodeficiencies Unit, Pediatric Allergy and Clinical Immunology Department, Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
Bruno Montoro, J.:: 2 Hosp Univ Vall dHebron, Pharm Serv, Barcelona, Spain
Moral PM:: 3 Hosp Univ & Politecn La Fe, Secc Inmunopatol & Enfermedades Minoritarias, Valencia, Spain
Neth O:: 4 Hosp Univ Virgen del Rocio, Rheumatol & Immunol Unit, Paediat Infect Dis, Inst Biomed Sevilla IBiS, Seville, Spain
Ortiz Pica, Marta:: 5 Hosp Clin San Carlos, Hosp Dia Med, Madrid, Spain
Sánchez-Ramón S:: 6 Univ Complutense Madrid, Hosp Clin San Carlos, Dept Inmunol Clin, IML, Madrid, Spain
Presa M:: 7 Pharmacoecon & Outcomes Res Iberia PORIB, Madrid, Spain
Oyagüez I:: 7 Pharmacoecon & Outcomes Res Iberia PORIB, Madrid, Spain
Angel Casado, Miguel:: 7 Pharmacoecon & Outcomes Res Iberia PORIB, Madrid, Spain
Ignacio Gonzalez-Granado, Luis:: 8 Univ Hosp 12 Octubre, Primary Immunodeficiencies Unit, Res Inst Hosp, Pediat, Madrid, Spain

9 Univ Complutense Madrid, Sch Med, Pediat, Madrid, Spain

Keywords

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

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