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

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Date

2021-09-21

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Alsina, Laia
Montoro, J Bruno
Moral, Pedro Moral
Neth, Olaf
Pica, Marta Ortiz
Sánchez-Ramón, Silvia
Presa, María
Oyagüez, Itziar
Casado, Miguel Ángel
González-Granado, Luis Ignacio

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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.

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Adult
Child
Hospital Costs
Humans
Immunoglobulins, Intravenous
Immunologic Deficiency Syndromes
Primary Immunodeficiency Diseases
Spain

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

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