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

Laia Alsina, J. Bruno Montoro, Pedro Moral Moral, Olaf Neth, Marta Ortiz Pica, Silvia Sánchez-Ramón, María Presa, Itziar Oyagüez, Miguel Ángel Casado and Luis Ignacio González-Granado ()
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Laia Alsina: Hospital Sant Joan de Déu, Universitat de Barcelona
J. Bruno Montoro: Hospital Universitari Vall d’Hebron
Pedro Moral Moral: Sección de Inmunopatología Y Enfermedades Minoritarias, Hospital Universitari I Politècnic La Fe
Olaf Neth: Hospital Universitario Virgen del Rocío/Instituto de Biomedicina de Sevilla (IBiS)
Marta Ortiz Pica: Hospital Clínico San Carlos
Silvia Sánchez-Ramón: IML, Hospital Clínico San Carlos, Universidad Complutense of Madrid
María Presa: Pharmacoeconomics and Outcomes Research Iberia (PORIB)
Itziar Oyagüez: Pharmacoeconomics and Outcomes Research Iberia (PORIB)
Miguel Ángel Casado: Pharmacoeconomics and Outcomes Research Iberia (PORIB)
Luis Ignacio González-Granado: University Hospital 12 Octubre/Research Institute Hospital

The European Journal of Health Economics, 2022, vol. 23, issue 3, No 12, 558 pages

Abstract: 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.

Keywords: Primary immunodeficiency disease; Immune system; Immunoglobulin replacement therapy; Subcutaneous immunoglobulin; Intravenous immunoglobulin; Cost-minimization analysis (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1007/s10198-021-01378-x

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