medigraphic.com
Órgano Oficial del Instituto Nacional de Pediatría

2022, Number 3

<< Back Next >>

Acta Pediatr Mex 2022; 43 (3)

Economic Burden of Primary Immunodeficiencies estimated by Real-life Evidence at National Institute of Pediatrics

Bustamante-Ogando JC, Partida-Gaytán A, Scheffler-Mendoza S, Rivas-Larrauri F, Yamazaki-Nakashimada MA, Hernández-Bautista, VM, García-Ramírez M, Maciel H, Espinosa-Padilla SE, Espinosa-Rosales F

Language: Spanish
References: 22
Page: 156-166
PDF size: 268.15 Kb.


ABSTRACT

Background: Primary Immunodeficiencies (PID) are genetic disorders impairing the immune system. Approximately, 85% of PID patients will need replacement therapy with human immunoglobulin (IG). Diagnosis and treatment delay may produce complications, and elevated expenses for the health systems.
Objectives: To evaluate the economic burden of PID and to compare the financial load before and after the initiation of replacement treatment with IG.
Methods: Health care costs analysis in patients with PID. We obtained information about health resources use directly from clinical records through a bottom-up approach, it was revised by clinical immunologists, and we developed medical-economic cards for registering resource allocation and costs. We then ran a budget impact analysis by a top-down approach considering the 109 PID patients currently under clinical follow-up at our institution.
Results: Total cost for treating infections per patient per year before diagnosis and IG replacement was MXN$ 629,299.00 vs MXN$ 155,546.00 after IG treatment, resulting in 75.3% cost reduction. Pneumonia is the most expensive complication. After initiating IG therapy, the total cost of treating infections reduced to MXN$ 155,546.00 representing 75.3% in savings. Total costs per infections estimated for 109 patients before diagnosis and treatment was MXN$ 68.5 million vs MXN$ 36 million after IG treatment. Based on the reference population for our institution, per-capita cost was MXN$ 3.96 before vs MXN$ 2.10 after IG treatment.
Conclusions: Timely diagnosis and treatment of PID patients with IG significantly decreased the per-capita costs of health care by MXN$ 1.87, which represents annual savings of 47%.


REFERENCES

  1. Picard C, Gaspar HB, Al-Herz W, Boufisha A, Casanova JL,et al. International Union of Immunological Societies: 2017Primary Immunodeficiency Diseases Committee Reporton Inborn Errors of Immunity. J Clin Immunol 2017. DOI:10.1007/s10875-017-0464-9.

  2. Costa-Carvalho BT, Grumach AS, Franco JL, Espinosa-Rosales FJ, Leiva LE, King A, Porras O, Bezrodnik L, OleastroM, Sorensen RU, Condino-Neto A. Attending to WarningSigns of Primary Immunodeficiency. Diseases across theRange of Clinical Practice. J Clin Immunol 2014; 34:10–22.DOI 10.1007/s10875-013-9954-6.

  3. Aghamohammadi A, Montazeri A, Abolhassani H, et al.Health-Related Quality of Life in Primary Antibody Deficiency.Iran J Allergy Asthma Immunol 2011; 10(1): 47-51.

  4. Broides A, Nahum A, Mandola AB, Rozner L, Pinsk V,Ling G, Yerushalmi B, Levy J, Givon-Lavi N. Incidence oftypically Severe Primary Immunodeficiency Diseases inConsanguineous and Non-consanguineous Populations.J Clin Immunol. 2017; DOI 10.1007/s10875-017-0378-6.

  5. Registro Latinoamericano de Inmunodeficiencias Primarias,sitio web: https://registrolasid.org/estatisticas.html.(consultado el 24/abril/2020).

  6. García-Cruz ML, Camacho R, Ortega-Martell JA, Berron-Pérez R, Espinosa-Rosales FJ, Hernández-Bautista V, Rojas-Garrido A. Registro de IDP en pacientes mexicanos en unainstitución de tercer nivel: experiencia de 30 años. Alergia,Asma e Inmunología Pediátrica 2002; 11 (2): 48-66.

  7. Guaní-Guerra E, Jiménez-Romero A, García-Ramírez U. Diseaseburden for patients with primary immunodeficiencydiseases identified at reference hospitals in Guanajuato,Mexico. PLoS ONE 2017; 12(4): e0175867. https://doi.org/10.1371/journal.pone.0175867.

  8. Bruton OC. Agammaglobulinemia. Pediatrics 1952; 9 (6):722-28.

  9. Elsink K, Van Montfrans J, Van Gijn E, Blom M, VanHagen PM, et al. Cost and Impacto f Early Diagnosis inPrimary Immunodeficiency Disease: A Literature Review.Clin Immunology 2019; doi: https://doi.org/10.1016/j.clim.2020.108359

  10. Bonagura VR, Marchlewski R, Cox A, Rosenthal DW. BiologicIgG level in primary immunodeficiency disease: The IgGlevel that protects against recurrent infection. J AllergyClin Immunology 2008; 122: 210-12.

  11. Guillevin L. Pharmacoeconomics of immunoglobulins andindications for their use. Curr Opin Allergy Clin Immunol2013; 13 (Suppl 2): S53-5.

  12. Rider N, Kutac C, Hajjar J. Health-Related Quality of Life inAdult Patients with Common Variable ImmunodeficiencyDisorders and impact of Treatment. J Clin Immunol 2017;37; 461-75.

  13. Titman P, Allwood Z, Gilmour C. Quality of Life in Childrenwith Primary Antibody Deficiency. J Clin Immunol 2014;34: 844-852.

  14. Vargas-Pieck A, Bustamante-Ogando JC, Muriel-Vizcaíno R,Espinosa-Rosales F. Calidad de vida en InmunodeficienciasPrimarias. Alergia, Asma e Inmunología Pediátricas 2011;20 (2): 57-64.

  15. Muriel-Vizcaíno R, Treviño-Garza G, Murata C, Staines-Boone T, Yamazaki-Nakashimana MA, Espinosa-Padilla SE,Espinosa-Rosales F. Calidad de vida de los pacientes coninmunodeficiencias primarias de anticuerpos. Acta PediatrMex 2016; 37(1): 17-25.

  16. Abolhassani H, Aghamohammadi A, Abolhassani F, EftekarH, Heidarnia M, Rezaei N. Health policy for common variableimmunodeficiency: burden of the disease. J InvestigAllergol Clin Immuno 2011; 21(6): 454-8.

  17. Angelis A, Tordrup D, Kanavos P. Socio-economic burdenof rare diseases: A systematic review of cost of illnessevidence. Health Policy 2015; 119: 964-979.

  18. López-Bastida J, Oliva-Moreno J. Cost of Illness and EconomicEvaluation in Rare Diseases. Adv Exp Med Biol 2010;686: 273-82.

  19. Gardulf A, Möller G, Jonsson E. A comparison of the patientbornecosts of therapy with gamma globulin given at thehospital or at home. Int J Technol Assess Health Care 1995;11(2): 345-353.

  20. Gardulf A, Anderson V, Björkander J, Ericson D, Froland SS,Gustafson R, et al. Subcutaneous immunoglobulin replacementin patients with primary antibody deficiencies: safetyand costs. Lancet 1995; 345(8946): 365-9.

  21. Chapel H, Prevot J, Gaspar HB, Español T, Bonilla F, SolisL, Drabwell J. Primary Immune Deficiencies – Principlesof Care. Front Immunol 2014; 5 (627). doi:10.3389/fimmu.2014.00627.

  22. Modell V, Q. J. (2016). Primary Immunodeficiencies worldwide:an updated overview from the Jeffrey Modell CentersGlobal Network. Immunol Res 2016; 64: 736-753.




2020     |     www.medigraphic.com