Cost-minimization analysis of immunoglobulin treatment of primary immunodeficiency diseases in Spain
Por:
Alsina L, Montoro JB, Moral PM, Neth O, Pica MO, Sánchez-Ramón S, Presa M, Oyagüez I, Casado MÁ and González-Granado LI
Publicada:
1 abr 2022
Ahead of Print:
1 sep 2021
Resumen:
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 euro4,266 lower for patients with PID who received SCIG (total euro14,466) compared with those who received IVIG (total euro18,732). The two largest contributors were differences in annual IG costs as a function of dosage (- euro1,927) and hospital administration costs (- euro2,688). However, SCIG incurred training costs for home administration (euro695). 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.
Filiaciones:
Alsina L:
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
Montoro JB:
Pharmacy Service, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Moral PM:
Sección de Inmunopatología Y Enfermedades Minoritarias, Hospital Universitari I Politècnic La Fe, Valencia, Spain
Neth O:
Paediatric Infectious Diseases, Rheumatology and Immunology Unit, Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS), Sevilla, Spain
Pica MO:
Hospital de Día Médico, Hospital Clínico San Carlos, Madrid, Spain
Sánchez-Ramón S:
Departamento de Inmunología Clínica, IML, Hospital Clínico San Carlos, Universidad Complutense of Madrid, Madrid, Spain
Presa M:
Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
Oyagüez I:
Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
Casado MÁ:
Pharmacoeconomics and Outcomes Research Iberia (PORIB), Madrid, Spain
González-Granado LI:
Primary Immunodeficiencies Unit, Pediatrics, University Hospital 12 Octubre/Research Institute Hospital, 12 octubre (i+12), Madrid, Spain.
Pediatrics, School of Medicine, Complutense University, Madrid, Spain.
Green Submitted, hybrid
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