Economic evaluation of immunoglobulin replacement in patients with primary antibody deficiencies

J. Beauté, Pierre Lévy, V. Millet, M. Debré, Y. Dudoit, L. Le Mignot, A. Tajahmady, C. Thomas, F. Suarez, I. Pellier, O. Hermine (), N. Aladjidi, N. Mahlaoui and A. Fischer
Additional contact information
J. Beauté: CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
Pierre Lévy: LEDa - Laboratoire d'Economie de Dauphine - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres, Legos - Laboratoire d'Economie et de Gestion des Organisations de Santé - Université Paris Dauphine-PSL - PSL - Université Paris Sciences et Lettres
Y. Dudoit: CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
L. Le Mignot: CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
F. Suarez: CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
O. Hermine: CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
N. Mahlaoui: CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)
A. Fischer: CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP) - Hôpital Necker - Enfants Malades [AP-HP] - AP-HP - Assistance publique - Hôpitaux de Paris (AP-HP)

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Abstract: Lifelong immunoglobulin replacement is the standard, expensive therapy for severe primary antibody deficiencies. This treatment can be administrated either by intravenous immunoglobulin (IVIG) or subcutaneous infusions (SCIG) and delivered at home or in an out-patient setting. This study aims to determine whether SCIG is cost-effective compared with IVIG from a French social insurance perspective. Because both methods of administration provide similar efficacies, a cost-minimization analysis was performed. First, costs were calculated through a simulation testing different hypothesis on costs drivers. Secondly, costs were estimated on the basis of field data collected by a questionnaire completed by a population of patients suffering from agammaglobulinaemia and hyper-immunoglobulin (Ig)M syndrome. Patients' satisfaction was also documented. Results of the simulation showed that direct medical costs ranged from €19 484 for home-based IVIG to €25 583 for hospital-based IVIG, with home-based SCIG in between at €24 952 per year. Estimations made from field data were found to be different, with significantly higher costs for IVIG. This result was explained mainly by a higher immunoglobulin mean dose prescribed for IVIG. While the theoretical model showed very little difference between SCIG and hospital-based IVIG costs, SCIG appears to be 25% less expensive with field data because of lower doses used in SCIG patients. The reality of the dose difference between both routes of administration needs to be confirmed by further and more specific studies.

Keywords: Evaluation; Medical economics; Cost of Medical care; Health Insurance; Medical care (search for similar items in EconPapers)
Date: 2010
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Citations: View citations in EconPapers (3)

Published in Clinical and Experimental Immunology, 2010, 160 (2), ⟨10.1111/j.1365-2249.2009.04079.x⟩

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Persistent link: https://EconPapers.repec.org/RePEc:hal:journl:hal-01293729

DOI: 10.1111/j.1365-2249.2009.04079.x

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