Luis Ignacio González-Granado, Spain
Hospital U. 12 Octubre Immunodeficiencies Unit, Department of PediatricsPresenter of 1 Presentation
COST ANALYSIS OF IV AND SC IMMUNOGLOBULINS USED IN THE TREATMENT OF PRIMARY IMMUNODEFICIENCY DISEASE IN SPAIN
Abstract
Background and Aims
Patients with primary immunodeficiency disease (PID) who require immunoglobulin (IG) replacement (IGRT) receive either intravenous IG (IVIG) or subcutaneous IG (SCIG), which provide equivalent efficacy. Using the Spanish National Health system and societal perspectives, this study developed a cost-minimization analysis to evaluate costs of SCIG versus IVIG.
Methods
The base case modeled the annual cost/mg of IVIG and SCIG for the mean doses (established by clinical consensus) over a 1-year time horizon in terms of direct (drug and administration) and indirect (lost productivity for adults [45% assumed working] and parents of pediatric patients [64% assumed working]) costs. Adults (≥19 years) comprised 52.5% of the model population. IVIG was assumed to be administered in a day hospital, whereas SCIG was predominantly (95%) 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.
Results
The annual modeled costs were €4,338/mg lower for patients with PID who received SCIG (total: €14,394/mg) compared with those who received IVIG (total: €18,732/mg). Annual modeled costs were lower for both adult (–€1,773/mg) and pediatric (–€2,565/mg) patients. The two largest contributors were differences in annual immunoglobulin costs and dosage (–€1,927/mg) and annual hospital administration costs (–€2,688). However, SCIG incurred training costs for home administration (€695/year). Costs of pre-medication, dispensing, and indirect costs were also included in the model.
Conclusions
Our model suggests that SCIG may represent a cost-saving alternative to IVIG for patients with PID in Spain.