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



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Alsina, Laia and Montoro, J. Bruno and Moral, Pedro Moral and Neth, Olaf and Ortiz Pica, Marta and Sánchez Ramón, Silvia María and Presa, María and Oyagüez, Itziar and Casado, Miguel Ángel and González Granado, Luis Ignacio (2021) Cost-minimization analysis of immunoglobulin treatment of primary immunodeficiency diseases in Spain. The European Journal of Health Economics . ISSN 1618-7598

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Primary immunodefciency 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 efcacy. We developed a costminimization 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 diferences 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.

Item Type:Article
Uncontrolled Keywords:Primary immunodefciency disease; Immune system; Immunoglobulin replacement therapy; Subcutaneous immunoglobulin; Intravenous immunoglobulin; Cost-minimization analysis
Subjects:Medical sciences > Medicine > Immunology
Medical sciences > Medicine > Public health
ID Code:69378
Deposited On:22 Dec 2021 12:55
Last Modified:22 Dec 2021 12:57

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